Interesting article I ran across on Journal Watch:
Implantable cardioverter-defibrillators for preventing sudden cardiac death had no effect on all-cause mortality in women with advanced heart failure.
Although women constitute a minority of participants in most clinical trials on treatments for cardiovascular disease — and few such studies are sufficiently powered to address sex-specific outcomes — benefits are usually assumed to apply equally to men and women. In a meta-analysis of five randomized controlled trials of implantable cardioverter-defibrillators (ICDs) for prevention of sudden cardiac death (SCD) in patients with heart failure, researchers asked whether survival benefits conferred by these devices in men also extend to women.
In a pooled population of 934 women and 3810 men, investigators compared outcomes of ICDs versus medical therapy in patients with low left ventricular ejection fraction with or without histories of arrhythmia. The hazard ratio for the effect of ICD implantation on all-cause mortality was 0.78 in men (P<0.001) and 1.01 in women.
Comment: These results suggest that the benefits of ICDs for primary prevention of sudden cardiac death in women are questionable. As an editorialist notes, what's good for the gander might not be good for the goose, at least regarding ICDs. Clearly, we need additional sex-specific data — not only about ICDs, but also about cardiovascular interventions in general. For now, clinicians should inform women that the proven benefits of ICDs for the primary prevention of SCD seem to be limited to men.
My thoughts; It is understood that coronary artery disease has taken a lead as the number one killer of women-and still least understood disease process in this group. As such, why is the medical community still taking a back seat in including women in clinical trials so they can better understand how the disease manifests in women allowing better preventative measures and treatment?
Underwriting "Term Du Jour": ICD: Implantable cardioverter-defibrillators
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