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Implantable cardioverter defibrillators: do women fare worse than men? Gender comparison in the INTRINSIC RV trial.
J Cardiovasc Electrophysiol. 2009 Sep; 20(9):973-8.JC

Abstract

INTRODUCTION

Due to limited enrollment of women in previous trials, there is a paucity of data comparing outcome and arrhythmic events in men versus women with implantable cardioverter defibrillators (ICDs).

METHODS AND RESULTS

We analyzed outcome of patients in the INTRINSIC RV (Inhibition of Unnecessary RV Pacing with AV Search Hysteresis in ICDs) trial based on gender. Women comprised 19% (293/1530) of the INTRINSIC RV population. Compared with men, women were less likely to have coronary disease, ischemic cardiomyopathy, and hyperlipidemia, and were more likely to have congestive heart failure and diabetes. Women were less likely to receive beta blockers and ACE inhibitors, and more likely to receive diuretics. Over 10.8 +/- 3.5 months of follow-up, unadjusted mortality was higher in women than men (6.8% vs 4.1%, P = 0.04). Heart failure hospitalizations occurred in 7.9% of women versus 5.7% of men (P = 0.13). After adjustment for baseline differences and drug therapy, there was no significant difference in mortality between men and women. Adverse events were observed more often in women. There were no gender differences in the percentage of patients receiving appropriate or inappropriate ICD shocks.

CONCLUSIONS

In INTRINSIC RV, women receiving ICDs differed from men regarding baseline characteristics and drug therapy. After adjusting for baseline differences and medical therapy, there were no differences in heart failure hospitalization, survival, or ICD shock therapy during follow-up. Apparent undertreatment of heart failure and greater frequency of adverse advents in women receiving ICDs warrant further investigation.

Authors+Show Affiliations

University of Pennsylvania, Philadelphia, Pennsylvania, USA. russo-andrea@cooperhealth.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

19470037

Citation

Russo, Andrea M., et al. "Implantable Cardioverter Defibrillators: Do Women Fare Worse Than Men? Gender Comparison in the INTRINSIC RV Trial." Journal of Cardiovascular Electrophysiology, vol. 20, no. 9, 2009, pp. 973-8.
Russo AM, Day JD, Stolen K, et al. Implantable cardioverter defibrillators: do women fare worse than men? Gender comparison in the INTRINSIC RV trial. J Cardiovasc Electrophysiol. 2009;20(9):973-8.
Russo, A. M., Day, J. D., Stolen, K., Mullin, C. M., Doraiswamy, V., Lerew, D. L., & Olshansky, B. (2009). Implantable cardioverter defibrillators: do women fare worse than men? Gender comparison in the INTRINSIC RV trial. Journal of Cardiovascular Electrophysiology, 20(9), 973-8. https://doi.org/10.1111/j.1540-8167.2009.01489.x
Russo AM, et al. Implantable Cardioverter Defibrillators: Do Women Fare Worse Than Men? Gender Comparison in the INTRINSIC RV Trial. J Cardiovasc Electrophysiol. 2009;20(9):973-8. PubMed PMID: 19470037.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Implantable cardioverter defibrillators: do women fare worse than men? Gender comparison in the INTRINSIC RV trial. AU - Russo,Andrea M, AU - Day,John D, AU - Stolen,Kira, AU - Mullin,Christopher M, AU - Doraiswamy,Vinayak, AU - Lerew,Darin L, AU - Olshansky,Brian, Y1 - 2009/05/12/ PY - 2009/5/28/entrez PY - 2009/5/28/pubmed PY - 2009/12/16/medline SP - 973 EP - 8 JF - Journal of cardiovascular electrophysiology JO - J Cardiovasc Electrophysiol VL - 20 IS - 9 N2 - INTRODUCTION: Due to limited enrollment of women in previous trials, there is a paucity of data comparing outcome and arrhythmic events in men versus women with implantable cardioverter defibrillators (ICDs). METHODS AND RESULTS: We analyzed outcome of patients in the INTRINSIC RV (Inhibition of Unnecessary RV Pacing with AV Search Hysteresis in ICDs) trial based on gender. Women comprised 19% (293/1530) of the INTRINSIC RV population. Compared with men, women were less likely to have coronary disease, ischemic cardiomyopathy, and hyperlipidemia, and were more likely to have congestive heart failure and diabetes. Women were less likely to receive beta blockers and ACE inhibitors, and more likely to receive diuretics. Over 10.8 +/- 3.5 months of follow-up, unadjusted mortality was higher in women than men (6.8% vs 4.1%, P = 0.04). Heart failure hospitalizations occurred in 7.9% of women versus 5.7% of men (P = 0.13). After adjustment for baseline differences and drug therapy, there was no significant difference in mortality between men and women. Adverse events were observed more often in women. There were no gender differences in the percentage of patients receiving appropriate or inappropriate ICD shocks. CONCLUSIONS: In INTRINSIC RV, women receiving ICDs differed from men regarding baseline characteristics and drug therapy. After adjusting for baseline differences and medical therapy, there were no differences in heart failure hospitalization, survival, or ICD shock therapy during follow-up. Apparent undertreatment of heart failure and greater frequency of adverse advents in women receiving ICDs warrant further investigation. SN - 1540-8167 UR - https://www.unboundmedicine.com/medline/citation/19470037/Implantable_cardioverter_defibrillators:_do_women_fare_worse_than_men_Gender_comparison_in_the_INTRINSIC_RV_trial_ L2 - https://doi.org/10.1111/j.1540-8167.2009.01489.x DB - PRIME DP - Unbound Medicine ER -