Abstract 3579: Gender/Etiology Paradox After Cardiac Resynchronization Therapy: The Insync/Insync ICD Italian Registries
Introduction. Cardiac reshynchronization therapy (CRT) with or without defibrillator capabilities (ICD) has been shown to reduce combined mortality and hospitalization in heart failure (HF) patients (pts). Few data compare the incidence of death between men and women after CRT implantation. We reviewed mortality data of pts enrolled in the InSync/InSync ICD Italian Registries to evaluate the survival according to gender in ischemic and non ischemic patients.
Methods. 952 pts (67±10 years, 778 males) with systolic HF and CRT indications were enrolled in the InSync/InSync ICD Italian Registries and followed up for a median follow-up of 18 months.
Results. At baseline evaluation females were older (p=0,005), males more frequently had ischemic etiology (p=0,0001), history of previous myocardial infarction (p=0,0001) and ICDs (p=0,0001). QRS duration, presence of chronic atrial fibrillation, left ventricular ejection fraction, left ventricular end-diastolic and end-systolic diameters assessed by echocardiography were not different in the 2 groups. Survival curves stratified by gender and adjusted for all baseline variables (Cox regression) showed a higher all-cause mortality risk in males with non ischemic etiology (HR=2.86, CI 1.37–5.98, p=0.005, Log Rank test p=0.004), while in the ischemic pts the difference was not present (Log Rank test p=0.143) (Fig. 1⇓).
Conclusion. The data pointed out that all-cause mortality, in male non-ischemic HF pts after CRT therapy is higher than in female pts, despite similar baseline characteristics.