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Comparative Effectiveness of Implantable Cardioverter Defibrillators for Primary Prevention in Women.

Publication ,  Journal Article
Zeitler, EP; Hellkamp, AS; Schulte, PJ; Fonarow, GC; Hernandez, AF; Peterson, ED; Sanders, GD; Yancy, CW; Al-Khatib, SM
Published in: Circ Heart Fail
January 2016

BACKGROUND: Clinical trials of implantable cardioverter defibrillators (ICDs) for primary prevention enrolled a limited number of women. We sought to examine clinical practice data to compare survival rates among women with heart failure with or without a primary prevention ICD. METHODS AND RESULTS: We linked data from 264 US hospitals included in the Get With The Guidelines for Heart Failure registry with data from the Centers for Medicare and Medicaid Services. From these sources, we propensity score matched 430 women with heart failure who received a primary prevention ICD to 430 women who did not; we further adjusted using a Cox proportional hazards model. Median follow-up was 3.4 and 3.0 years. For comparison, we matched 859 men receiving an ICD with 859 who did not; median follow-up was 3.9 versus 2.9 years. In the matched cohorts, an ICD was associated with similarly better survival in women (hazard ratio, 0.78; 95% confidence interval, 0.66-0.92; P=0.003) and men (hazard ratio, 0.76; 95% confidence interval, 0.67-0.87 P<0.001). There was no interaction between sex and presence of an ICD with respect to survival (P=0.79). CONCLUSIONS: Among patients with heart failure with reduced left ventricular ejection fraction, a primary prevention ICD was associated with a significant survival advantage among women and among men. These findings support guideline-directed use of primary prevention ICDs in eligible patients.

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Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

January 2016

Volume

9

Issue

1

Start / End Page

e002630

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • United States
  • Treatment Outcome
  • Time Factors
  • Stroke Volume
  • Sex Factors
  • Risk Factors
  • Risk Assessment
  • Registries
  • Proportional Hazards Models
 

Citation

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Zeitler, E. P., Hellkamp, A. S., Schulte, P. J., Fonarow, G. C., Hernandez, A. F., Peterson, E. D., … Al-Khatib, S. M. (2016). Comparative Effectiveness of Implantable Cardioverter Defibrillators for Primary Prevention in Women. Circ Heart Fail, 9(1), e002630. https://doi.org/10.1161/CIRCHEARTFAILURE.115.002630
Zeitler, Emily P., Anne S. Hellkamp, Phillip J. Schulte, Gregg C. Fonarow, Adrian F. Hernandez, Eric D. Peterson, Gillian D. Sanders, Clyde W. Yancy, and Sana M. Al-Khatib. “Comparative Effectiveness of Implantable Cardioverter Defibrillators for Primary Prevention in Women.Circ Heart Fail 9, no. 1 (January 2016): e002630. https://doi.org/10.1161/CIRCHEARTFAILURE.115.002630.
Zeitler EP, Hellkamp AS, Schulte PJ, Fonarow GC, Hernandez AF, Peterson ED, et al. Comparative Effectiveness of Implantable Cardioverter Defibrillators for Primary Prevention in Women. Circ Heart Fail. 2016 Jan;9(1):e002630.
Zeitler, Emily P., et al. “Comparative Effectiveness of Implantable Cardioverter Defibrillators for Primary Prevention in Women.Circ Heart Fail, vol. 9, no. 1, Jan. 2016, p. e002630. Pubmed, doi:10.1161/CIRCHEARTFAILURE.115.002630.
Zeitler EP, Hellkamp AS, Schulte PJ, Fonarow GC, Hernandez AF, Peterson ED, Sanders GD, Yancy CW, Al-Khatib SM. Comparative Effectiveness of Implantable Cardioverter Defibrillators for Primary Prevention in Women. Circ Heart Fail. 2016 Jan;9(1):e002630.

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

January 2016

Volume

9

Issue

1

Start / End Page

e002630

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • United States
  • Treatment Outcome
  • Time Factors
  • Stroke Volume
  • Sex Factors
  • Risk Factors
  • Risk Assessment
  • Registries
  • Proportional Hazards Models