title: Use of Implantable Cardioverter Defibrillators in Heart Failure Patients and Risk of Mortality: A Meta-Analysis.
abstract: BACKGROUND
  The purpose of this study was to evaluate the effect of implantable cardioverter defibrillators (ICD) in heart failure (HF) patients compared to pharmacologic/conventional management.
  
  
  METHODS
  We searched PubMed, Embase, and Springer Link Library databases up to February 10th, 2014. Pooled risk ratio (RR) and 95% confidence interval (CI) for the mortality of the patients with HF were collected and calculated in a fixed-effects model or a random-effects model, as appropriate. Summary effect estimates were also stratified by sex and follow-up time. Egger's regression asymmetry tests were utilized for publication bias detection.
  
  
  RESULTS
  A total of 7 separate studies including 15 520 patients (10 801 ICD cases and 4719 controls) with HF were considered in the meta-analysis. The overall estimates showed that ICD could statistically significantly reduce the mortality of male (RR=0.73, 95% CI: 0.66-0.80) and female (RR=0.75, 95% CI: 0.63-0.90) patients. In addition, the further stratification subgroup analysis indicated that ICD presented a significant reduction (male: RR=0.72, 95% CI: 0.64-0.81; female: RR=0.69, 95% CI: 0.56-0.85) of mortality after 2-3 years of ICD therapy. The RR (95% CI) effects of mortality after 4-5 years of ICD therapy for males and females were 0.76 (0.51-1.14) and 0.96 (0.68-1.37), respectively.
  
  
  CONCLUSIONS
  This meta-analysis suggests that ICD could reduce HF patient mortality despite the sex difference.
authors.affiliation: Department of Cardiology, Xuanwu Hospital of Capital Medical University, Beijing, China (mainland).
authors.forename: Yucong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Xuanwu Hospital of Capital Medical University, Beijing, China (mainland).
authors.forename: Kang
authors.initials: K
authors.lastname: Li
mesh_terms: D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany; D006333:Heart Failure / Q000401:mortality* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D015233:Models, Statistical; D016017:Odds Ratio; D039781:PubMed; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014481:United States