Yarnoz Michael J, Curtis Anne B
Division of Cardiovascular Disease, University of South Florida, Tampa, Florida 33612, USA.
Cardiol Rev. 2006 Nov-Dec;14(6):292-8. doi: 10.1097/01.crd.0000244462.33052.72.
With the rapid advancements in heart failure device therapy, many physicians now use these devices in everyday clinical practice. However, questions remain regarding the clinical benefit of these therapies in different patient subgroups. Since the majority of patients enrolled in device trials are white men, extrapolating the data to specific patient subpopulations becomes important. Specifically, the question of clinical outcomes in women with implantable device therapy for prevention of sudden cardiac death and management of heart failure is an important clinical issue. In this article, we review the data on survival and clinical outcomes with heart failure device therapy (implantable cardioverter defibrillators [ICDs] and cardiac resynchronization therapy [CRT]) and analyze the results from clinical trials for any differences in outcomes based on gender. Even though women are a significantly under-represented population with regard to clinical investigation and utilization of heart failure devices, they still derive the same morbidity and mortality benefits compared to men. Specifically, ICD devices confer the same rates of sudden cardiac death prevention, and CRT devices improve CHF morbidity and mortality at rates comparable to those found in men. These results support equal use of ICDs and CRT in men and women.
随着心力衰竭器械治疗的迅速发展，许多医生现在在日常临床实践中使用这些器械。然而，关于这些治疗方法在不同患者亚组中的临床益处仍存在疑问。由于参与器械试验的大多数患者是白人男性，因此将数据外推至特定患者亚群变得很重要。具体而言，对于接受植入式器械治疗以预防心源性猝死和管理心力衰竭的女性患者，其临床结局问题是一个重要的临床问题。在本文中，我们回顾了心力衰竭器械治疗（植入式心脏复律除颤器[ICD]和心脏再同步治疗[CRT]）的生存数据和临床结局，并分析了临床试验结果中基于性别的结局差异。尽管在心力衰竭器械的临床研究和使用方面，女性的代表性明显不足，但与男性相比，她们仍能获得相同的发病率和死亡率益处。具体而言，ICD器械预防心源性猝死的发生率相同，CRT器械改善CHF发病率和死亡率的速率与男性相当。这些结果支持在男性和女性中平等使用ICD和CRT。
