Cardiac resynchronization with defibrillator more effective in women than men
MedWire News: Results from a subanalysis of the MADIT-CRT trial indicate that women who receive cardiac resynchronization therapy with defibrillator (CRT-D) to prevent heart failure (HF) have a significantly lower risk for death or heart failure than men with the same device.
Lead researcher Arthur Moss (University of Rochester Medical Center, New York, USA) commented: "It's not that men did poorly in the trial, but rather, women had really fantastic results, likely due to the type of heart disease we see more commonly in women."
He added: "Our finding was unexpected, but extremely important because this is the only heart treatment that is clearly better in women than men."
The subanalysis of the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy) trial involved 1367 male and 453 female heart disease patients from 110 medical centers in the USA, Canada, and Europe. All patients were randomly allocated to receive CRT-D or an implantable cardioverter-defibrillator (ICD) alone.
The researchers assessed the rates of the primary outcome of HF or death (whichever came first) over a mean follow-up period of 2.4 years.
Writing in the Journal of the American College of Cardiology, Moss and team report that 376 patients died (n=54) or had HF (n=322) during the follow-up period.
A higher proportion of men with CRT-D met the primary outcome than women with the same device, at 20% versus 11%. Conversely, more women with ICD met the primary outcome than men with ICD, at 29% versus 25%.
Overall, women who received CRT-D therapy had significantly better outcomes than women with ICD or men with either device, with a 69% reduction in death or HF and 70% reduction in HF alone(p<0.001 for both).
Moss et al note that "the more favorable results for women were associated with consistently greater echocardiographic evidence of reverse cardiac remodeling in women than men."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Lauretta Ihonor