Jude ElSaygh, Laura Bradel, Kevin Pink, Lu Chen, Jonathan Arnedo, Bharath Reddy, Brian Wong, Jeremy Berman, Stephen J Peterson, Wilber S Aronow, Gioia Turitto
{"title":"Do gender differences persist in ICD implantation in patients with acute on chronic heart failure?","authors":"Jude ElSaygh, Laura Bradel, Kevin Pink, Lu Chen, Jonathan Arnedo, Bharath Reddy, Brian Wong, Jeremy Berman, Stephen J Peterson, Wilber S Aronow, Gioia Turitto","doi":"10.1080/14796678.2025.2484958","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Implantable Cardiac Defibrillators (ICDs) prolong survival in patients with heart failure with reduced ejection fraction (HFrEF). Despite strong data suggesting their benefit, there is concern for disparities related to ICD implantation rates.</p><p><strong>Methods: </strong>A retrospective analysis of 551 patients admitted to a single tertiary institution from June 2020 to May 2023, who met the guideline criteria for ICD implantation for primary prevention of sudden cardiac death, was carried out.</p><p><strong>Results: </strong>Our population constituted of 56% African Americans, 20% Caucasians, 1% Asians and 2% Native Americans. Of those patients, 47% (157/337) of males and 33% (71/213) of females underwent ICD implantation before discharge, creating a statistically significant gender difference at <i>p</i> = 0.007. Patients aged 50 or greater (218/509) were more likely to receive an ICD compared to younger patients (10/41) at <i>p</i> = 0.000. Of those offered an ICD, 46% deferred to outpatient, 30% refused, and 8% of patient had history of noncompliance, were medically unstable, or were undecided.</p><p><strong>Conclusion: </strong>Females and younger patients were less likely to have an ICD at discharge. Despite strong recommendations for ICD implantation in eligible patients, most patients did not receive an ICD. This study showcases the limited access to care and highlights potential avenues of improvement.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"365-370"},"PeriodicalIF":1.6000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026163/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Future cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/14796678.2025.2484958","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/30 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Implantable Cardiac Defibrillators (ICDs) prolong survival in patients with heart failure with reduced ejection fraction (HFrEF). Despite strong data suggesting their benefit, there is concern for disparities related to ICD implantation rates.
Methods: A retrospective analysis of 551 patients admitted to a single tertiary institution from June 2020 to May 2023, who met the guideline criteria for ICD implantation for primary prevention of sudden cardiac death, was carried out.
Results: Our population constituted of 56% African Americans, 20% Caucasians, 1% Asians and 2% Native Americans. Of those patients, 47% (157/337) of males and 33% (71/213) of females underwent ICD implantation before discharge, creating a statistically significant gender difference at p = 0.007. Patients aged 50 or greater (218/509) were more likely to receive an ICD compared to younger patients (10/41) at p = 0.000. Of those offered an ICD, 46% deferred to outpatient, 30% refused, and 8% of patient had history of noncompliance, were medically unstable, or were undecided.
Conclusion: Females and younger patients were less likely to have an ICD at discharge. Despite strong recommendations for ICD implantation in eligible patients, most patients did not receive an ICD. This study showcases the limited access to care and highlights potential avenues of improvement.
期刊介绍:
Research advances have contributed to improved outcomes across all specialties, but the rate of advancement in cardiology has been exceptional. Concurrently, the population of patients with cardiac conditions continues to grow and greater public awareness has increased patients" expectations of new drugs and devices. Future Cardiology (ISSN 1479-6678) reflects this new era of cardiology and highlights the new molecular approach to advancing cardiovascular therapy. Coverage will also reflect the major technological advances in bioengineering in cardiology in terms of advanced and robust devices, miniaturization, imaging, system modeling and information management issues.