title: Gender-specific differences in clinical outcome of primary prevention implantable cardioverter defibrillator recipients.
abstract: OBJECTIVE
  To assess differences in clinical outcome of implantable cardioverter-defibrillator (ICD) treatment in men and women.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  University Medical Center.
  
  
  METHODS
  1946 primary prevention ICD recipients (1528 (79%) men and 418 (21%) women). Patients with congenital heart disease were excluded for this analysis.
  
  
  METHODS
  All-cause mortality, ICD therapy (antitachycardia pacing and shock) and ICD shock.
  
  
  RESULTS
  During a median follow-up of 3.3 years (25th-75th percentile 1.4-5.4), 387 (25%) men and 76 (18%) women died. The estimated 5-year cumulative incidence for all-cause mortality was 20% (95% CI 18% to 23%) for men and 14% (95% CI 9% to 19%) for women (log rank p<0.01). After adjustment for potential confounding covariates all-cause mortality was lower in women (HR 0.65; 95% CI 0.49 to 0.84; p<0.01). The 5-year cumulative incidence for appropriate therapy in men was 24% (95% CI 21% to 28%) as compared with 20% (95% CI 14% to 26%) in women (log rank p=0.07). After adjustment, a non-significant trend remained (HR 0.82; 95% CI 0.64 to 1.06; p=0.13).
  
  
  CONCLUSIONS
  In clinical practice, 21% of primary prevention ICD recipients are women. Women have lower mortality and tend to experience less appropriate ICD therapy as compared with their male peers.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Aafke C
authors.initials: AC
authors.lastname: van der Heijden
authors.forename: Joep
authors.initials: J
authors.lastname: Thijssen
authors.forename: C Jan Willem
authors.initials: CJ
authors.lastname: Borleffs
authors.forename: Johannes B
authors.initials: JB
authors.lastname: van Rees
authors.forename: Ulas
authors.initials: U
authors.lastname: Höke
authors.forename: Enno T
authors.initials: ET
authors.lastname: van der Velde
authors.forename: Lieselot
authors.initials: L
authors.lastname: van Erven
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000628:therapy*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012737:Sex Factors; D016896:Treatment Outcome
keywords: Arrhythmias