Gender-related differences in outcomes of patients with cardiac resynchronization therapy

Roman Nevzorov, Avital Porter, Shanie Mostov, Shirit Kazum, Alon Eisen, Gustavo Goldenberg, Zaza Iakobishvili, Jairo Kusniec, Gregory Golovchiner, Boris Strasberg, Moti Haim

    Research output: Contribution to journalArticlepeer-review

    2 Scopus citations

    Abstract

    Background: Gender-related differences (GRD) exist in the outcome of patients with cardiac resynchronization therapy (CRT). Objectives: To assess GRD in patients who underwent CRT. Methods: A retrospective cohort of 178 patients who were implanted with a CRT in a tertiary center 2005–2009 was analyzed. Primary outcome was 1 year mortality. Secondary endpoints were readmission and complication rates. Results: No statistically significant difference was found in 1 year mortality rates (14.6% males vs. 11.8% females, P = 0.7) or in readmission rate (50.7% vs. 41.2%, P = 0.3). The complication rate was only numerically higher in women (14.7% vs. 5.6%, P = 0.09). Men more often had CRT-defibrillator (CRT-D) implants (63.2% vs. 35.3%, P = 0.003) and had a higher rate of ischemic cardiomyopathy (79.2% vs. 38.2%, P < 0.001). There was a trend to higher incidence of ventricular fibrillation/ventricular tachycardia in men before CRT implantation (29.9% vs. 14.7%, P = 0.07%). A higher proportion of men upgraded from implantable cardioverter defibrillator (ICD) to CRT-D, 20.8% vs. 8.8%, P = 0.047. On multivariate model, chronic renal failure was an independent predictor of 1 year mortality (hazard ratio [HR] 3.6; 95% confidence interval [95%CI] 1.4–9.5), CRT-D had a protective effect compared to CRT-pacemaker (HR 0.3, 95%CI 0.12–0.81). Conclusions: No GRD was found in 1 year mortality or readmission rates in patients treated with CRT. There was a trend toward a higher complication rate in females. Men were implanted more often with CRT-D and more frequently underwent upgrading of ICD to CRT-D.

    Original languageEnglish
    Pages (from-to)311-315
    Number of pages5
    JournalIsrael Medical Association Journal
    Volume20
    Issue number5
    StatePublished - 1 May 2018

    Keywords

    • Cardiac resynchronization therapy (CRT)
    • Chronic heart failure (CHF)
    • Gender differences
    • Implantable cardioverter defibrillator (ICD)

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