Sex-specific clinical outcomes after cardiac resynchronization therapy in left bundle branch block-associated idiopathic nonischemic cardiomyopathy: A NEOLITH II substudy.

Autor:	Wang NC; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Mezu-Chukwu U; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Adelstein EC; Albany Medical Center, Albany, New York., Althouse AD; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Sharbaugh MS; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Jain SK; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Shalaby AA; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Voigt AH; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Saba S; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Jazyk:	angličtina
Zdroj:	Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc [Ann Noninvasive Electrocardiol] 2019 Jul; Vol. 24 (4), pp. e12641. Date of Electronic Publication: 2019 Mar 27.
DOI:	10.1111/anec.12641
Abstrakt:	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. (© 2019 Wiley Periodicals, Inc.)
Databáze:	MEDLINE
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