More Favorable Response to Cardiac Resynchronization Therapy in Women Than in Men

Cheng, Yun‐Jiu; Zhang, Jing; Li, Weijie; Lin, Xuemei; Zeng, Wenjing; Tang, Kai; Tang, Anli; He, Jing; Xu, Qing; Mei, Mei-Yi; Zheng, Dong-Dan; Dong, Yugang; Ma, Hong; Wu, Shuizhu

doi:10.1161/circep.113.001786

Cited by 75 publications

(52 citation statements)

References 69 publications

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“…For both primary and second endpoints, females exhibited a reduction of 33% and 42% in the rate of all-cause mortality and heart failure hospitalization or heart failure, respectively. These results are very similar to those presented in a previous meta-analysis by Cheng [67] in 2014. However, in the latter analysis, clinical factors including follow-up duration, proportions of female patients, NYHA function class, and average LVEF were not subject to sex-related differences.…”

Section: Discussionsupporting

confidence: 92%

Sex-specific mortality differences in heart failure patients with ischemia receiving cardiac resynchronization therapy

et al. 2017

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BackgroundRecent studies have reported prognosis differences between male and female heart failure patients following cardiac resynchronization therapy (CRT). However, the potential clinical factors that underpin these differences remain to be elucidated.MethodsA meta-analysis was performed to investigate the factors that characterize sex-specific differences following CRT. This analysis involved searching the Medline (Pubmed source) and Embase databases in the period from January 1980 to September 2016.ResultsFifty-eight studies involving 33445 patients (23.08% of whom were women) were analyzed as part of this study. Only patients receiving CRT with follow-up greater than six months were included in our analysis. Compared with males, females exhibited a reduction of 33% (hazard ratio, 0.67; 95% confidence interval, 0.62–0.73; P < 0.0001) and 42% (hazard ratio, 0.58; 95% confidence interval, 0.46–0.74; P = 0.003) in all-cause mortality and heart failure hospitalization or heart failure, respectively. Following a stratified analysis of all-cause mortality, we observed that ischemic causes (p = 0.03) were likely to account for most of the sex-specific differences in relation to CRT.ConclusionThese data suggest that women have a reduced risk of all-cause mortality and heart failure hospitalization or heart failure following CRT. Based on the results from the stratified analysis, we observed more optimal outcomes for females with ischemic heart disease. Thus, ischemia are likely to play a role in sex-related differences associated with CRT in heart failure patients. Further studies are required to determine other indications and the potential mechanisms that might be associated with sex-specific CRT outcomes.

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Section: Discussionsupporting

confidence: 92%

Sex-specific mortality differences in heart failure patients with ischemia receiving cardiac resynchronization therapy

et al. 2017

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“…We calculated the I 2 (95% CI) statistic to assess heterogeneity across studies, 13 applying the following interpretation for I 2 : <50%, low heterogeneity; 50% to 75%, moderate heterogeneity; and >75%, high heterogeneity. 14,15 Sensitivity analyses were performed to evaluate whether the results could have been affected markedly by using fixed-effect model, trim and fill method, and different inclusion and exclusion criteria. Subgroup analyses and meta-regression models were performed to investigate potential sources of between-study heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

Risk of Thromboembolic Events in Atrial Fibrillation With Chronic Kidney Disease

Zeng

Sun

Tang

et al. 2015

Stroke

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Background and Purpose-Chronic kidney disease may increase the risk for ischemic stroke or systemic embolism in patients with nonvalular atrial fibrillation (AF). We conducted a meta-analysis to summarize all published studies to investigate the link between chronic kidney disease and risk of thromboembolic events in AF. Methods-We performed a literature search using MEDLINE (source PubMed, 1966 and EMBASE (1980 to July 2014) with no restrictions. Pooled effect estimates were obtained by using random-effects meta-analysis. Results-Eighteen studies involving 538 479 patients and 41 719 incident thromboembolic events were identified. From the pooled analysis, AF patients with estimated glomerular filtration rate <60 mL/min compared with those with estimated glomerular filtration rate ≥60 mL/min experienced a significantly increased risk for developing thromboembolic events (relative risk, 1.62 [95% confidence interval, 1.40-1.87; P<0.001]). The annual rate of thromboembolic events increased by 0.41% (95% confidence interval, 0.17%-0.65%) for a 10 mL/min decrease in renal function. Addition of renal impairment to CHADS 2 slightly improved the stroke risk stratification. Conclusions-Impaired renal function is an independent predictor of stroke or systemic embolism in patients with nonvalvular AF. Consideration of renal function may improve stroke risk stratification in patients with AF. (Stroke.

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“…Современным методом лечения ХСН является сердечная ресинхро-низирующая терапия (СРТ), эффекты которой приво-дят к ремоделированию сердца, уменьшению симпто-мов, снижению госпитализаций и смертности [2][3][4]. Ранее была продемонстрирована большая эффектив-ность СРТ у женщин [5][6][7][8]. Среди возможных при-чин, обусловливающих гендерную специфику ремоде-лирования сердца у женщин, были отмечены меньшие размеры сердца и длительность QRS, более высокий процент назначения β-АБ, дигоксина, антагонистов альдостерона [7], бóльшая динамика ремоделирова-ния сердца [6,9,10], более высокий процент бивен-трикулярной стимуляции [8,10,11], большая частота дилатационной кардиомиопатии [8,12] и полной бло-кады левой ножки пучка Гиса (ПБЛНПГ) [10], боль-шая частота у мужчин фибрилляции предсердий [5,7].…”

Section: Discussionunclassified

Biochemical aspects of gender differences in response to cardiac resynchronization therapy

Enina¹,

Кузнецов²,

Солдатова³

et al. 2017

RHJ

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More Favorable Response to Cardiac Resynchronization Therapy in Women Than in Men

Cited by 75 publications

References 69 publications

Sex-specific mortality differences in heart failure patients with ischemia receiving cardiac resynchronization therapy

Sex-specific mortality differences in heart failure patients with ischemia receiving cardiac resynchronization therapy

Risk of Thromboembolic Events in Atrial Fibrillation With Chronic Kidney Disease

Biochemical aspects of gender differences in response to cardiac resynchronization therapy

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