Mohamed, MO, Volgman, AS, Contractor, T, Sharma, PS, Kwok, CS ORCID: https://orcid.org/0000-0001-7047-1586, Rashid, M, Martin, GP, Barker, D, Patwala, A and Mamas, MA ORCID: https://orcid.org/0000-0001-9241-8890 (2019) Trends of sex differences in outcomes of cardiac electronic device implantations in the United States. Canadian Journal of Cardiology.

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Abstract

Background The disparity in outcomes of CIED implantations between sexes has been previously demonstrated in device-specific cohorts (e.g. implantable cardioverter defibrillators (ICD)). However, it is unclear whether sex differences are present with all types of CIED and, if so, what the trends of such differences were in recent years. Methods Using the National Inpatient Sample, all hospitalizations between 2004 and 2014 for de novo implantation of permanent pacemakers (PPM), cardiac resynchronization therapy with or without a defibrillator (CRT-D and CRT-P, respectively) and ICD were analyzed to examine the association between sex and in-hospital acute complications of CIED implantation. Results Out of 2,815,613 hospitalizations for de novo CIED implantation, 41.9% were performed on women. Women were associated with increased adjusted odds of adverse procedural complications (major adverse cardiovascular complications: 1.17 [1.16, 1.19], bleeding: 1.13 [1.12, 1.15], thoracic: 1.42 [1.40, 1.44], cardiac: 1.44 [1.38, 1.50]), while the adjusted odds of in-hospital all-cause mortality compared to men was 0.96 [0.94, 1.00]. The odds of adverse complications in the overall CIED cohort were persistently raised in women throughout the study period, whereas similar odds of all-cause mortality across the sexes were observed throughout the study period. Conclusion In a national cohort of CIED implantations we demonstrate that women are at an overall higher risk of procedure-related adverse events compared to men, but no increased risk of all-cause mortality. Further studies are required to identify procedural techniques that would improve outcomes amongst women undergoing such procedures.

Item Type: Article
Additional Information: The final version of this article is available online at https://www.sciencedirect.com/science/article/pii/S0828282X19311596?via%3Dihub
Uncontrolled Keywords: Cardiac devices; pacemakers; defibrillators; cardiac resynchronization; sex; trends; outcomes; treatment
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 10 Sep 2019 08:48
Last Modified: 10 Sep 2019 08:48
URI: http://eprints.keele.ac.uk/id/eprint/6786

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