Sex Specific Outcomes With Cardiac Resynchronization Therapy in Patients With Symptomatic Heart Failure Having Reduced Left Ventricular Ejection Fraction: A Systematic Review and Meta-Analysis

American journal of medicine open Pub Date : 2025-03-17 DOI:10.1016/j.ajmo.2025.100097

Muhammad Hamayal MBBS, Muhammad Arham Abbas MBBS, Momina Hafeez MBBS, Saira Mahmud MBBS, Warda Shahid MBBS, Saman Naeem MBBS, Hasan Shaukat Abbasi MBBS, Muhammad Danyal Tahir MBBS, Aleea Abbas MBBS, Iqra Iftikhar MBBS, Naaemah Saleem MBBS

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引用次数: 0

Abstract

Cardiac resynchronization therapy (CRT) has emerged instrumental in managing heart failure. Notably, there is a lack of evidence of CRT efficacy among both sexes. Thus, this meta-analysis focuses on the long-term benefits of CRT in both sexes. PubMed, The Cochrane Library and clinicaltrials.gov were searched for articles from 2010 to 2024. ROB2 was used to assess risk of bias of RCTs. Newcastle Ottawa Scale was used for quality appraisal of cohorts. Meta-analysis was conducted on Revman 5.4. Out of 2722 articles, only 9 RCTs and 18 cohorts were included. Our results demonstrated that females had a significantly lower risk of composite outcomes compared to males in both RCTs (RR 0.80; 95% CI [0.68, 0.94], P = .006) and cohorts (RR 0.76; 95% CI [0.63, 0.92], P = .004). Results were similar for all-cause mortality. For heart failure hospitalization, only cohorts showed a significant lesser risk in females (RR 0.78; 95% CI [0.65, 0.93], P = .006). Left ventricular ejection fraction improved significantly in females but no differences were observed for NYHA class improvement. Males showed a 31% lower survival rate. However future trials are needed to highlight this variation.

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左心室射血分数降低的症状性心力衰竭患者心脏再同步化治疗的性别特异性结局：系统回顾和荟萃分析

心脏再同步化治疗（CRT）已成为治疗心力衰竭的工具。值得注意的是，缺乏证据表明CRT对两性都有效。因此，本荟萃分析侧重于CRT对两性的长期益处。PubMed、Cochrane图书馆和clinicaltrials.gov检索了2010年至2024年的文章。ROB2用于评估随机对照试验的偏倚风险。采用纽卡斯尔渥太华量表对队列进行质量评价。采用Revman 5.4进行meta分析。在2722篇文章中，只有9篇rct和18个队列被纳入。我们的结果显示，在两项随机对照试验中，女性的综合结局风险显著低于男性(RR 0.80；95% CI [0.68, 0.94], P = 0.006)和队列(RR 0.76；95% ci [0.63, 0.92], p = 0.004)。全因死亡率的结果相似。对于心力衰竭住院治疗，只有女性队列的风险显着降低(RR 0.78；95% ci [0.65, 0.93], p = 0.006)。女性左室射血分数显著改善，但NYHA分级改善无差异。雄性的存活率低了31%。然而，需要未来的试验来突出这种差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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American journal of medicine open Medicine and Dentistry (General)

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审稿时长

47 days