Both women and men benefit from ICDs

January 13, 2016 – A study led by the DCRI’s Emily Zeitler, MD, found that current guidelines recommending implantable cardioverter defibrillators for heart failure patients applied to both men and women.

Implantable cardioverter defibrillators (ICDs) can provide a significant survival benefit to both women and men who suffer from heart failure with reduced left ventricular ejection fraction, according to a recent study by DCRI researchers.

The study, led by the DCRI’s Emily Zeitler, MD, appears in the current issue of Circulation: Heart Failure.

emily-zeitler-newsPrevious research has established that primary prevention ICDs confer a survival benefit to patients with heart failure and reduced ejection fraction. However, most of the randomized clinical trials that explored this topic enrolled primarily men. Consequently, there has been some question as to whether the observed survival benefit extends equally to women and men. Although some observational studies and meta-analyses have also addressed the issue of whether primary prevention ICDs benefit women, the results have been mixed.

To address this issue, Zeitler and her colleagues examined patient data from Get With The Guidelines for Heart Failure (GWTG-HF), a voluntary hospital-based improvement program, and the Centers for Medicare and Medicaid Services. They identified women in the GWTG-HF registry who were at least 65 years old, whose primary insurance was Medicare, and who were linked to Centers for Medicare and Medicaid Services data. The final study population included 430 women who had received an ICD and 430 women who did not. For comparison purposes, the researchers also matched 859 men receiving an ICD with 859 who did not

They found that after three years, 40.2 percent of women with ICDs had died, compared with 48.7 percent of women without devices. Meanwhile, 42.9 percent of men with ICDs had died, compared with 52.9 percent of men without devices. With an ICD, the risk of death was more than 20 percent lower in both men and women after about three years.

The researchers concluded that these findings support current guideline recommendations for the implantation of a primary prevention ICD in eligible women and men with heart failure and reduced left ventricular ejection fraction.

“Currently, many eligible patients with heart failure are not referred to physicians who can implant the devices. If you have heart failure, ask your doctor whether you might benefit from an ICD in addition to your other therapy,” Zeitler said in a press release issued by the journal.

In addition to Zeitler, the study’s DCRI authors included Anne Hellkamp, MS; Adrian Hernandez, MD, MHS; Eric Peterson, MD, MPH; Gillian Sanders, PhD; and Sana al-Khatib, MD, MHS.