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

作者：Yun‐Jiu Cheng, Jing Zhang, Weijie Li, Xiao‐Xiong Lin, Wu‐Tao Zeng, Kai Tang, Anli Tang, Jiangui He, Qing Xu, Mei-Yi Mei, Dong-Dan Zheng, Yugang Dong, Hong Ma, Su‐Hua Wu · 发表于：Circulation Arrhythmia and Electrophysiology · 年份：2014 · DOI：10.1161/circep.113.001786 · 被引用次数：80 · 研究领域：Cardiac pacing and defibrillation studies、Cardiac electrophysiology and arrhythmias、Heart Failure Treatment and Management

BACKGROUND: Data on sex difference in response to cardiac resynchronization therapy (CRT) remain controversial. We conducted a meta-analysis to summarize all published studies to determine whether sex-based differences in response to CRT exist. METHODS AND RESULTS: We performed a literature search using MEDLINE (source PubMed; January 1966 to March 2014) and EMBASE (January 1980 to March 2014) with no restrictions. Pooled effect estimates were obtained by using random-effects meta-analysis. Seventy-two studies involving 33 434 patients were identified. Overall, female patients had better outcomes from CRT compared with male patients, with a significant 33% reduction in the risk of death from any cause (hazard ratio, 0.67; 95% confidence interval, 0.61-0.74; P<0.001), 20% reduction in death or hospitalization for heart failure (hazard ratio, 0.80; 95% confidence interval, 0.71-0.90; P<0.001), 41% reduction in cardiac death (hazard ratio, 0.59; 95% confidence interval, 0.42-0.84; P<0.001), and 41% reduction in ventricular arrhythmias or sudden cardiac death (hazard ratio, 0.59; 95% confidence interval, 0.49-0.70; P<0.001). These more favorable responses to CRT in women were consistently associated with greater echocardiographic evidence of reverse cardiac remodeling in women than in men. CONCLUSIONS: Women obtained greater reductions in the risk of death from any cause, cardiac cause, death or hospitalization for heart failure, and ventricular arrhythmias or sudden cardiac deat...