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Sex‐specific clinical outcomes after cardiac resynchronization therapy in left bundle branch block‐associated idiopathic nonischemic cardiomyopathy: A NEOLITH II substudy
- Publication Year :
- 2019
- Publisher :
- John Wiley and Sons Inc., 2019.
-
Abstract
- Background Sex differences in clinical outcomes for left bundle branch block (LBBB)-associated idiopathic nonischemic cardiomyopathy (NICM) after cardiac resynchronization therapy (CRT) are not well described. Methods A retrospective cohort study at an academic medical center included subjects with LBBB-associated idiopathic NICM who received CRT. Cox regression analyses estimated the hazard ratios (HRs) between sex and clinical outcomes. Results In 123 total subjects (mean age 62 years, mean initial left ventricular ejection fraction 22.8%, 76% New York Heart Association class III, and 98% CRT-defibrillators), 55 (45%) were men and 68 (55%) were women. The median follow-up time after CRT was 72.4 months. Similar risk for adverse clinical events (heart failure hospitalization, appropriate implantable cardioverter-defibrillator shock, appropriate antitachycardia pacing therapy, ventricular assist device implantation, heart transplantation, and death) was observed between men and women (HR, 1.20; 95% confidence interval [CI] 0.57-2.51; p = 0.63). This persisted in multivariable analyses. Men and women had similar risk for all-cause mortality in univariable analysis, but men had higher risk in the final multivariable model that adjusted for age at diagnosis, QRS duration, and left ventricular end-diastolic dimension index (HR, 4.55; 95% CI, 1.26-16.39; p = 0.02). The estimated 5-year mortality was 9.5% for men and 6.9% for women. Conclusions In LBBB-associated idiopathic NICM, men have higher risk for all-cause mortality after CRT when compared to women.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Bundle-Branch Block
Cardiac resynchronization therapy
Electric Countershock
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Cardiac Resynchronization Therapy
Cohort Studies
03 medical and health sciences
QRS complex
0302 clinical medicine
Sex Factors
Physiology (medical)
Internal medicine
Medicine
Humans
030212 general & internal medicine
Retrospective Studies
Ejection fraction
business.industry
Left bundle branch block
Hazard ratio
Retrospective cohort study
General Medicine
Original Articles
Middle Aged
medicine.disease
Defibrillators, Implantable
Treatment Outcome
Ventricular assist device
Heart failure
Heart Transplantation
Female
Cardiology and Cardiovascular Medicine
business
Cardiomyopathies
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....d14c8238c0021a626c2db1c42bbbdda7