Sex differences in device therapy for heart failure: Utilization, outcomes, and adverse events

Naomi D. Herz, Joseph Engeda, Robbert Zusterzeel, William E. Sanders, Kathryn M. O'Callaghan, David G. Strauss, Samantha B. Jacobs, Kimberly A. Selzman, Ileana L. Pina, Daniel A. Caños

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Multiple studies of heart failure patients demonstrated significant improvement in exercise capacity, quality of life, cardiac left ventricular function, and survival from cardiac resynchronization therapy (CRT), but the underenrollment of women in these studies is notable. Etiological and pathophysiological differences may result in different outcomes in response to this treatment by sex. The observed disproportionate representation of women suggests that many women with heart failure either do not meet current clinical criteria to receive CRT in trials or are not properly recruited and maintained in these studies. Methods: We performed a systematic literature review through May 2014 of clinical trials and registries of CRT use that stratified outcomes by sex or reported percent women included. One-hundred eighty-three studies contained sex-specific information. Results: Ninety percent of the studies evaluated included ≤35% women. Fifty-six articles included effectiveness data that reported response with regard to specific outcome parameters. When compared with men, women exhibited more dramatic improvement in specific parameters. In the studies reporting hazard ratios for hospitalization or death, women generally had greater benefit from CRT. Conclusions: Our review confirms women are markedly underrepresented in CRT trials, and when a CRT device is implanted, women have a therapeutic response that is equivalent to or better than in men, while there is no difference in adverse events reported by sex.

Original languageEnglish (US)
Pages (from-to)261-271
Number of pages11
JournalJournal of Women's Health
Volume24
Issue number4
DOIs
StatePublished - Apr 1 2015
Externally publishedYes

Fingerprint

Sex Characteristics
Heart Failure
Cardiac Resynchronization Therapy
Equipment and Supplies
Therapeutics
Cardiac Resynchronization Therapy Devices
Left Ventricular Function
Registries
Hospitalization
Quality of Life
Clinical Trials
Exercise
Survival

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Herz, N. D., Engeda, J., Zusterzeel, R., Sanders, W. E., O'Callaghan, K. M., Strauss, D. G., ... Caños, D. A. (2015). Sex differences in device therapy for heart failure: Utilization, outcomes, and adverse events. Journal of Women's Health, 24(4), 261-271. https://doi.org/10.1089/jwh.2014.4980

Sex differences in device therapy for heart failure : Utilization, outcomes, and adverse events. / Herz, Naomi D.; Engeda, Joseph; Zusterzeel, Robbert; Sanders, William E.; O'Callaghan, Kathryn M.; Strauss, David G.; Jacobs, Samantha B.; Selzman, Kimberly A.; Pina, Ileana L.; Caños, Daniel A.

In: Journal of Women's Health, Vol. 24, No. 4, 01.04.2015, p. 261-271.

Research output: Contribution to journalArticle

Herz, ND, Engeda, J, Zusterzeel, R, Sanders, WE, O'Callaghan, KM, Strauss, DG, Jacobs, SB, Selzman, KA, Pina, IL & Caños, DA 2015, 'Sex differences in device therapy for heart failure: Utilization, outcomes, and adverse events', Journal of Women's Health, vol. 24, no. 4, pp. 261-271. https://doi.org/10.1089/jwh.2014.4980
Herz ND, Engeda J, Zusterzeel R, Sanders WE, O'Callaghan KM, Strauss DG et al. Sex differences in device therapy for heart failure: Utilization, outcomes, and adverse events. Journal of Women's Health. 2015 Apr 1;24(4):261-271. https://doi.org/10.1089/jwh.2014.4980
Herz, Naomi D. ; Engeda, Joseph ; Zusterzeel, Robbert ; Sanders, William E. ; O'Callaghan, Kathryn M. ; Strauss, David G. ; Jacobs, Samantha B. ; Selzman, Kimberly A. ; Pina, Ileana L. ; Caños, Daniel A. / Sex differences in device therapy for heart failure : Utilization, outcomes, and adverse events. In: Journal of Women's Health. 2015 ; Vol. 24, No. 4. pp. 261-271.
@article{f2f702abf126407cb10042113bf80576,
title = "Sex differences in device therapy for heart failure: Utilization, outcomes, and adverse events",
abstract = "Background: Multiple studies of heart failure patients demonstrated significant improvement in exercise capacity, quality of life, cardiac left ventricular function, and survival from cardiac resynchronization therapy (CRT), but the underenrollment of women in these studies is notable. Etiological and pathophysiological differences may result in different outcomes in response to this treatment by sex. The observed disproportionate representation of women suggests that many women with heart failure either do not meet current clinical criteria to receive CRT in trials or are not properly recruited and maintained in these studies. Methods: We performed a systematic literature review through May 2014 of clinical trials and registries of CRT use that stratified outcomes by sex or reported percent women included. One-hundred eighty-three studies contained sex-specific information. Results: Ninety percent of the studies evaluated included ≤35{\%} women. Fifty-six articles included effectiveness data that reported response with regard to specific outcome parameters. When compared with men, women exhibited more dramatic improvement in specific parameters. In the studies reporting hazard ratios for hospitalization or death, women generally had greater benefit from CRT. Conclusions: Our review confirms women are markedly underrepresented in CRT trials, and when a CRT device is implanted, women have a therapeutic response that is equivalent to or better than in men, while there is no difference in adverse events reported by sex.",
author = "Herz, {Naomi D.} and Joseph Engeda and Robbert Zusterzeel and Sanders, {William E.} and O'Callaghan, {Kathryn M.} and Strauss, {David G.} and Jacobs, {Samantha B.} and Selzman, {Kimberly A.} and Pina, {Ileana L.} and Ca{\~n}os, {Daniel A.}",
year = "2015",
month = "4",
day = "1",
doi = "10.1089/jwh.2014.4980",
language = "English (US)",
volume = "24",
pages = "261--271",
journal = "Journal of Women's Health",
issn = "1540-9996",
publisher = "Mary Ann Liebert Inc.",
number = "4",

}

TY - JOUR

T1 - Sex differences in device therapy for heart failure

T2 - Utilization, outcomes, and adverse events

AU - Herz, Naomi D.

AU - Engeda, Joseph

AU - Zusterzeel, Robbert

AU - Sanders, William E.

AU - O'Callaghan, Kathryn M.

AU - Strauss, David G.

AU - Jacobs, Samantha B.

AU - Selzman, Kimberly A.

AU - Pina, Ileana L.

AU - Caños, Daniel A.

PY - 2015/4/1

Y1 - 2015/4/1

N2 - Background: Multiple studies of heart failure patients demonstrated significant improvement in exercise capacity, quality of life, cardiac left ventricular function, and survival from cardiac resynchronization therapy (CRT), but the underenrollment of women in these studies is notable. Etiological and pathophysiological differences may result in different outcomes in response to this treatment by sex. The observed disproportionate representation of women suggests that many women with heart failure either do not meet current clinical criteria to receive CRT in trials or are not properly recruited and maintained in these studies. Methods: We performed a systematic literature review through May 2014 of clinical trials and registries of CRT use that stratified outcomes by sex or reported percent women included. One-hundred eighty-three studies contained sex-specific information. Results: Ninety percent of the studies evaluated included ≤35% women. Fifty-six articles included effectiveness data that reported response with regard to specific outcome parameters. When compared with men, women exhibited more dramatic improvement in specific parameters. In the studies reporting hazard ratios for hospitalization or death, women generally had greater benefit from CRT. Conclusions: Our review confirms women are markedly underrepresented in CRT trials, and when a CRT device is implanted, women have a therapeutic response that is equivalent to or better than in men, while there is no difference in adverse events reported by sex.

AB - Background: Multiple studies of heart failure patients demonstrated significant improvement in exercise capacity, quality of life, cardiac left ventricular function, and survival from cardiac resynchronization therapy (CRT), but the underenrollment of women in these studies is notable. Etiological and pathophysiological differences may result in different outcomes in response to this treatment by sex. The observed disproportionate representation of women suggests that many women with heart failure either do not meet current clinical criteria to receive CRT in trials or are not properly recruited and maintained in these studies. Methods: We performed a systematic literature review through May 2014 of clinical trials and registries of CRT use that stratified outcomes by sex or reported percent women included. One-hundred eighty-three studies contained sex-specific information. Results: Ninety percent of the studies evaluated included ≤35% women. Fifty-six articles included effectiveness data that reported response with regard to specific outcome parameters. When compared with men, women exhibited more dramatic improvement in specific parameters. In the studies reporting hazard ratios for hospitalization or death, women generally had greater benefit from CRT. Conclusions: Our review confirms women are markedly underrepresented in CRT trials, and when a CRT device is implanted, women have a therapeutic response that is equivalent to or better than in men, while there is no difference in adverse events reported by sex.

UR - http://www.scopus.com/inward/record.url?scp=84928037645&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84928037645&partnerID=8YFLogxK

U2 - 10.1089/jwh.2014.4980

DO - 10.1089/jwh.2014.4980

M3 - Article

C2 - 25793483

AN - SCOPUS:84928037645

VL - 24

SP - 261

EP - 271

JO - Journal of Women's Health

JF - Journal of Women's Health

SN - 1540-9996

IS - 4

ER -