Women Less Likely than Men to Receive ICDs

(Ivanhoe Newswire) -- Women do not get the same treatment as men to protect them from sudden cardiac death -- the leading cause of death in the United States.

A new report shows men are about two- to three-times more likely than women to receive an implantable cardioverter-defibrillator (ICD) to prevent sudden cardiac death.

The risk of sudden cardiac death overall increases with age and is higher in men than in women but the sex difference narrows and eventually disappears after age 85 years. Research has shown ICDs to be effective in preventing sudden cardiac death. Medicare coverage of the devices has expanded but many eligible patients still do not receive them.

Researchers at Duke University School of Medicine looked at the differences between men and women receiving ICDs for primary and secondary prevention of sudden cardiac death. Participants were age 65 or older with Medicare fee-for-service coverage. All had been diagnosed with a heart attack and either heart failure or cardiomyopathy -- a disorder of the heart muscle.

In the primary prevention group, 32.3 per 1,000 men and 8.6 per 1,000 women received ICD therapy within one year of entering the study. Results show men were about 3.2 times more likely than women to receive an ICD. Among men and women alive 180 days after the study began, the risk of death in the subsequent year was not much lower among those who got ICD therapy.

In the secondary prevention group, 102.2 per 1,000 men and 38.4 per 1,000 women got ICD therapy. Results show men were 2.4-times more likely than women to receive ICD therapy. Among men and women alive 30 days after the study began, the risk of death in the subsequent year was 35-percent lower among patients who received ICD therapy.

The authors conclude there is a need for “an improved understanding of sex differences in patterns of care.” 

This article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://www.ivanhoe.com/newsalert/.

SOURCE: Journal of the American Medical Association, 2007;298:1517-1524