title: Women have better long-term prognosis than men after cardiac resynchronization therapy.
abstract: OBJECTIVE
  Cardiac resynchronization therapy (CRT) improves prognosis in patients with moderate-to-severe heart failure, reduced left ventricular ejection fraction, and wide QRS complexes. However, CRT may be under-utilized in women and data on long-term follow-up are still scarce. The aim was to investigate long-term mortality and hospitalization and prognostic impact of gender after CRT.
  
  
  RESULTS
  Data on 619 consecutive patients (19% women) that received CRT at a single centre between 1998 and 2008 were collected from electronic medical records and national death and hospitalization registries up to 2010. The primary endpoint was death of any cause and the secondary endpoint was combined death of any cause or heart failure hospitalization. Over a mean follow-up of 1320 ± 786 days, 215 (35%) patients reached the primary endpoint and 437 (71%) the secondary endpoint. Overall, 1-, 5-, and 10-year survivals were 91, 63, and 39%, respectively. Female gender was the only independent predictor of all-cause mortality; hazard ratio (HR) 0.44 [95% confidence interval (CI), 0.21-0.90; P= 0.025]. Women also had a trend towards lower risk for the secondary endpoint, HR 0.68 (95% CI, 0.45-1.04; P= 0.072).
  
  
  CONCLUSIONS
  In this registry analysis, patients with CRT had similarly high short-term survival to those in controlled trials, and this favourable prognosis was sustained over the long term.Women had lower all-cause mortality than men.
authors.affiliation: Section for Heart Failure, Department of Cardiology, Karolinska University Hospital, 17176 Stockholm, Sweden.
authors.forename: Stanislava
authors.initials: S
authors.lastname: Zabarovskaja
authors.forename: Fredrik
authors.initials: F
authors.lastname: Gadler
authors.forename: Frieder
authors.initials: F
authors.lastname: Braunschweig
authors.forename: Marcus
authors.initials: M
authors.lastname: Ståhlberg
authors.forename: Jonas
authors.initials: J
authors.lastname: Hörnsten
authors.forename: Cecilia
authors.initials: C
authors.lastname: Linde
authors.forename: Lars H
authors.initials: LH
authors.lastname: Lund
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D055815:Young Adult