Clinical research in cardiology : official journal of the German Cardiac Society · 2025
Impact of sex on the utilization of defibrillation-capable cardiac implantable devices and outcome: results from the German device registry.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Popescu Sorin Ștefan, Gasperetti Alessio, Brachmann Johannes, Eckardt Lars, Kuck Karl-Heinz, Willems Stephan, Lugenbiel Patrick, Akin Ibrahim, Meyer Christian, Schmidtke Claudia, Schneider Steffen, Hochadel Matthias, Senges Jochen, Tilz Roland Richard
Аннотация
BACKGROUND AND AIMS: Implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy with defibrillation-function (CRT-D) are widely used in patients with life-threatening arrhythmias or heart failure. We aim to investigate the impact of sex-specific differences on defibrillation-capable cardiac devices' implantation and outcomes.
METHODS: The German DEVICE registry is a prospective, multicentre database of ICD and CRT device implantation. A total of 5330 patients receiving a defibrillation-capable device were prospectively enrolled in 44 centres between March 2007 and February 2014 and followed for 17 (13, 23) months.
RESULTS: A minority of patients in this registry was female 1017 (19.1%). The rate of CRT-D use among the defibrillator recipients was higher in women (32.4% vs. 28.0%; p = 0.006). The incidence of major periprocedural complications and in-hospital complications were higher in women (3.3% vs. 1.6%; p = 0.001 and 5.5% vs. 3.6%; p = 0.017, respectively). The 1-year all-cause mortality was 5.5% for women and 7.4% for men (p = 0.039), while the 1-year cardiovascular mortality was 4.1% and 6.2%, respectively (p = 0.012). Less women received device shocks during 1-year follow-up (10.7% vs. 13.8%; p = 0.023). Women receiving CRT-D had a lower non-device-related cardiovascular hospitalization rate than men. System revision until discharge, in-hospital death and non-fatal complications during follow-up were comparable for men and women. Similar rates of all-cause and cardiac rehospitalizations were found.
CONCLUSIONS: In this real-life patient cohort only a minority of patients was female. Female patients had a higher risk of major periprocedural complications and in-hospital complications but a lower all-cause and cardiovascular mortality. Less women experienced device-shocks during follow-up.
METHODS: The German DEVICE registry is a prospective, multicentre database of ICD and CRT device implantation. A total of 5330 patients receiving a defibrillation-capable device were prospectively enrolled in 44 centres between March 2007 and February 2014 and followed for 17 (13, 23) months.
RESULTS: A minority of patients in this registry was female 1017 (19.1%). The rate of CRT-D use among the defibrillator recipients was higher in women (32.4% vs. 28.0%; p = 0.006). The incidence of major periprocedural complications and in-hospital complications were higher in women (3.3% vs. 1.6%; p = 0.001 and 5.5% vs. 3.6%; p = 0.017, respectively). The 1-year all-cause mortality was 5.5% for women and 7.4% for men (p = 0.039), while the 1-year cardiovascular mortality was 4.1% and 6.2%, respectively (p = 0.012). Less women received device shocks during 1-year follow-up (10.7% vs. 13.8%; p = 0.023). Women receiving CRT-D had a lower non-device-related cardiovascular hospitalization rate than men. System revision until discharge, in-hospital death and non-fatal complications during follow-up were comparable for men and women. Similar rates of all-cause and cardiac rehospitalizations were found.
CONCLUSIONS: In this real-life patient cohort only a minority of patients was female. Female patients had a higher risk of major periprocedural complications and in-hospital complications but a lower all-cause and cardiovascular mortality. Less women experienced device-shocks during follow-up.