JACC: CRT-D therapy works twice as well in women
Women had a 70 percent decrease in heart failure and 72 percent reduction in death when undergoing cardiac resynchronization therapy with defibrillator (CRT-D) when compared with men, according to sub-analysis of the MADIT-CRT trial published in the Feb. 7 issue of the Journal of the American College of Cardiology.
"In prior cardiac studies, men and women generally received similar benefit from preventive medical therapy," wrote lead author Arthur J. Moss, MD, of the University of Rochester Medical Center in Rochester, N.Y.
The MADIT-CRT trial (2009) included 1,820 participants from 110 medical centers in the U.S., Canada and Europe and compared the effectiveness of CRT-D versus implantable cardioverter-defibrillator (ICD) treatment in reducing heart failure and death. Twenty-five percent of the study participants were female.
Moss and colleagues assessed the reasons why outcomes differed for both women and men when CRT-D therapy (Boston Scientific) was used. The researchers reported that while women were more likely to have non-ischemic heart disease and left bundle branch block (LBBB), men were more likely to have ischemic heart disease (coronary artery disease).
Due to the fact that LBBB and non-ischemic heart disease diffuse heart problems, women may be more responsive to CRT-D therapy, which strengthens the mechanical pumping action of the heart and coordinates the heart’s electrical activity.
During the study, the primary endpoint of heart failure and death occurred in 376 patients—11 percent in women with CRT-D, 29 percent in women with ICD, 20 percent in men with CRT-D and 25 percent in men with ICD. The endpoint included 54 deaths and 322 HF events.
The researchers also found that women who received CRT-D therapy to prevent HF progression had better outcomes compared with men who received the same therapy. The reduction of HF was double, 70 percent versus 35 percent.
Moss et al found that in women who had mild HF, CRT-D therapy prevented deterioration of the heart (cardiac remodeling) by preventing its enlargement.
“Historically, heart disease has been dominated by its association with men. But, thanks to successful awareness campaigns in recent years, such as the American Heart Association's Go Red for Women initiative, women have started to take note of their risks and take action to protect their health,” the authors concluded. "These more favorable results for women were associated with consistently greater echocardiographic evidence of reverse cardiac remodeling in women than in men."
"In prior cardiac studies, men and women generally received similar benefit from preventive medical therapy," wrote lead author Arthur J. Moss, MD, of the University of Rochester Medical Center in Rochester, N.Y.
The MADIT-CRT trial (2009) included 1,820 participants from 110 medical centers in the U.S., Canada and Europe and compared the effectiveness of CRT-D versus implantable cardioverter-defibrillator (ICD) treatment in reducing heart failure and death. Twenty-five percent of the study participants were female.
Moss and colleagues assessed the reasons why outcomes differed for both women and men when CRT-D therapy (Boston Scientific) was used. The researchers reported that while women were more likely to have non-ischemic heart disease and left bundle branch block (LBBB), men were more likely to have ischemic heart disease (coronary artery disease).
Due to the fact that LBBB and non-ischemic heart disease diffuse heart problems, women may be more responsive to CRT-D therapy, which strengthens the mechanical pumping action of the heart and coordinates the heart’s electrical activity.
During the study, the primary endpoint of heart failure and death occurred in 376 patients—11 percent in women with CRT-D, 29 percent in women with ICD, 20 percent in men with CRT-D and 25 percent in men with ICD. The endpoint included 54 deaths and 322 HF events.
The researchers also found that women who received CRT-D therapy to prevent HF progression had better outcomes compared with men who received the same therapy. The reduction of HF was double, 70 percent versus 35 percent.
Moss et al found that in women who had mild HF, CRT-D therapy prevented deterioration of the heart (cardiac remodeling) by preventing its enlargement.
“Historically, heart disease has been dominated by its association with men. But, thanks to successful awareness campaigns in recent years, such as the American Heart Association's Go Red for Women initiative, women have started to take note of their risks and take action to protect their health,” the authors concluded. "These more favorable results for women were associated with consistently greater echocardiographic evidence of reverse cardiac remodeling in women than in men."