Abstract 12233: Gender Differences in Outcomes After Cardiac Resynchronization Therapy: A Systematic Review, and Meta Analysis of Prospective Studies With Meta-Regression
Background: Gender related differences in outcome have been observed in cardiac resynchronization therapy (CRT) patients, although the literature has conflicting reports.
Methods: After comprehensive literature search, 5 prospective (2 randomized) studies reporting outcomes for the composite endpoint of first hospitalization for heart failure or death, at a follow-up duration of > 1 year were included in the meta analysis and male and female cohorts were compared. The table lists study characteristics. Meta-regression analysis was performed, evaluating the association between the proportion of non-ischemic cardiomyopathy (NICMP) patients and the composite endpoint.
Results: A significantly larger reduction in the composite outcome of first heart failure hospitalization and mortality was noted in women treated with CRT compared to men (O.R = 0.658, 95% C.I ranging from 0.49 to 0.89, Z = -2.768, P = 0.0001). This is depicted in the figure. Meta-regression analysis showed no significant association between the proportion of NICMP and incremental outcome benefit (slope = 0.025, P = 0.939).
Conclusion: Women treated with CRT derive a larger improvement in outcomes compared to men. This outcome difference is not explained by the differences in etiologic mix of left ventricular systolic dysfunction (LVSD).
- © 2013 by American Heart Association, Inc.