Do gender differences persist in ICD implantation in patients with acute on chronic heart failure?

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Future cardiology Pub Date : 2025-05-01 Epub Date: 2025-03-30 DOI:10.1080/14796678.2025.2484958
Jude ElSaygh, Laura Bradel, Kevin Pink, Lu Chen, Jonathan Arnedo, Bharath Reddy, Brian Wong, Jeremy Berman, Stephen J Peterson, Wilber S Aronow, Gioia Turitto
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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.

急慢性心力衰竭患者ICD植入是否存在性别差异?
背景:植入式心脏除颤器(ICDs)可延长心力衰竭伴射血分数降低(HFrEF)患者的生存期。尽管强有力的数据表明它们的益处,但人们担心与ICD植入率相关的差异。方法:回顾性分析2020年6月至2023年5月在一所高等教育机构住院的551例符合ICD植入术一级预防心源性猝死指南标准的患者。结果:我们的人口由56%的非洲裔美国人,20%的高加索人,1%的亚洲人和2%的印第安人组成。其中47%(157/337)的男性和33%(71/213)的女性患者在出院前植入ICD,性别差异有统计学意义(p = 0.007)。50岁及以上的患者(218/509)比年轻患者(10/41)更有可能接受ICD (p = 0.000)。在提供ICD的患者中,46%推迟到门诊,30%拒绝,8%的患者有不遵医嘱的病史,医学不稳定或未决定。结论:女性和年轻患者在出院时发生ICD的可能性较小。尽管强烈建议在符合条件的患者中植入ICD,但大多数患者并未接受ICD。这项研究显示了获得护理的机会有限,并强调了潜在的改进途径。
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来源期刊
Future cardiology
Future cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.80
自引率
5.90%
发文量
87
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.
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