Sex differences among subcutaneous defibrillator (S-ICD) recipients: a propensity-matched, multicenter, international analysis from the i-SUSI project.
S-ICD
appropriate shocks
gender differences
sex differences
sudden cardiac death
Journal
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
ISSN: 1532-2092
Titre abrégé: Europace
Pays: England
ID NLM: 100883649
Informations de publication
Date de publication:
02 May 2024
02 May 2024
Historique:
received:
28
02
2024
revised:
27
03
2024
accepted:
02
04
2024
medline:
2
5
2024
pubmed:
2
5
2024
entrez:
2
5
2024
Statut:
aheadofprint
Résumé
Women have been historically underrepresented in implantable cardioverter defibrillator (ICD) trials. No data on sex differences regarding subcutaneous-ICDs (S-ICD) carriers have been described. Aim of our study was to investigate sex-related differences among unselected S-ICD recipients. Consecutive patients enrolled in the multicenter, international i-SUSI registry were analyzed. Comparisons between sexes were performed using a 1:1 propensity matching adjusted analysis for age, body mass index (BMI), left ventricular function and substrate. The primary outcome was the rate of appropriate shocks during follow-up. Inappropriate shocks and other device-related complications were deemed secondary outcomes. A total of 1698 patients were extracted from the iSUSI registry; 399 (23.5%) were females. After propensity matching, two cohorts of 374 patients presenting similar baseline characteristics were analyzed. Despite similar periprocedural characteristics and a matched BMI, women resulted at lower risk of conversion failure as per PRAETORIAN score (73.4% vs 81.3%, p = 0.049). Over a median follow-up time of 26.5 [12.7-42.5] months, appropriate shocks were more common in the male cohort (rate/year 3.4%vs1.7%; log-rank p = 0.049), while no significant differences in device-related complications (rate/year: 6.3% vs 5.8%; log-rank p = 0.595) and inappropriate shocks (rate/year: 4.3%vs3.1%; log-rank p = 0.375) were observed. After controlling for confounders, sex remained significantly associated with the primary outcome (aHR 1.648; CI 0.999-2.655, p = 0.048), while not resulting predictor of inappropriate shocks and device-related complications. In a propensity-matched cohort of S-ICD recipients, women are less likely to experience appropriate ICD therapy, while not showing higher risk of device related-complications.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Women have been historically underrepresented in implantable cardioverter defibrillator (ICD) trials. No data on sex differences regarding subcutaneous-ICDs (S-ICD) carriers have been described. Aim of our study was to investigate sex-related differences among unselected S-ICD recipients.
METHODS
METHODS
Consecutive patients enrolled in the multicenter, international i-SUSI registry were analyzed. Comparisons between sexes were performed using a 1:1 propensity matching adjusted analysis for age, body mass index (BMI), left ventricular function and substrate. The primary outcome was the rate of appropriate shocks during follow-up. Inappropriate shocks and other device-related complications were deemed secondary outcomes.
RESULTS
RESULTS
A total of 1698 patients were extracted from the iSUSI registry; 399 (23.5%) were females. After propensity matching, two cohorts of 374 patients presenting similar baseline characteristics were analyzed. Despite similar periprocedural characteristics and a matched BMI, women resulted at lower risk of conversion failure as per PRAETORIAN score (73.4% vs 81.3%, p = 0.049). Over a median follow-up time of 26.5 [12.7-42.5] months, appropriate shocks were more common in the male cohort (rate/year 3.4%vs1.7%; log-rank p = 0.049), while no significant differences in device-related complications (rate/year: 6.3% vs 5.8%; log-rank p = 0.595) and inappropriate shocks (rate/year: 4.3%vs3.1%; log-rank p = 0.375) were observed. After controlling for confounders, sex remained significantly associated with the primary outcome (aHR 1.648; CI 0.999-2.655, p = 0.048), while not resulting predictor of inappropriate shocks and device-related complications.
CONCLUSION
CONCLUSIONS
In a propensity-matched cohort of S-ICD recipients, women are less likely to experience appropriate ICD therapy, while not showing higher risk of device related-complications.
Identifiants
pubmed: 38696701
pii: 7663397
doi: 10.1093/europace/euae115
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
A Gasperetti
(A)
R Arosio
(R)
M Viecca
(M)
G B Forleo
(GB)
M Schiavone
(M)
F Tundo
(F)
M Moltrasio
(M)
C Tondo
(C)
M Ziacchi
(M)
I Diemberger
(I)
A Angeletti
(A)
M Biffi
(M)
N Fierro
(N)
S Gulletta
(S)
P Della Bella
(PD)
G Mitacchione
(G)
A Curnis
(A)
P Compagnucci
(P)
M Casella
(M)
A Dello Russo
(AD)
L Santini
(L)
C Pignalberi
(C)
M Magnocavallo
(M)
A Piro
(A)
C Lavalle
(C)
F Picarelli
(F)
D Ricciardi
(D)
E Bressi
(E)
L Calò
(L)
E Montemerlo
(E)
G Rovaris
(G)
S De Bonis
(S)
A Bisignani
(A)
G Bisignani
(G)
G Russo
(G)
E Pisanò
(E)
P Palmisano
(P)
F Guarracini
(F)
F Vitali
(F)
M Bertini
(M)
J Vogler
(J)
T Fink
(T)
R Tilz
(R)
F Fastenrath
(F)
J Kuschyk
(J)
L Kaiser
(L)
S Hakmi
(S)
M Laredo
(M)
X Waintraub
(X)
E Gandjbakhch
(E)
N Badenco
(N)
A Breitenstein
(A)
A M Saguner
(AM)
M Martine
(M)
S Seidl
(S)
X Zhang
(X)
L Di Biase
(L)
Informations de copyright
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.