Implantable Cardioverter Defibrillators (ICDs) May Not Curb Death in Women With Heart Failure, Research Review Shows
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Reviewed By Elizabeth Klodas, MD, FACC
The review, published in the Archives of Internal Medicine, is based on data from five studies that together included 3,810 men and 934 women with heart failure. Some of the patients got ICDs surgically implanted; others got medical care that didn't include getting an ICD.
Among men, ICDs were lifesavers. Men who got ICDs were 22% less likely to die than men who didn't get ICDs.
But it was a different story for women. There was no difference in the odds of dying from any cause between women who got an ICD and those who didn't. The likelihood of death was no better -- or worse -- with or without an ICD for women.
The reasons for that aren't clear, note the researchers, who included Hamid Ghanbari, MD, of the cardiology department at the Providence Hospital Heart Institute and Medical Center in Southfield, Mich.
Ghanbari's team speculates that ICDs may be better suited for men because of some underlying differences between men and women. The researchers also point out that ICDs have mainly been studied in men, so more research is needed to identify women would benefit the most from ICDs.
"Ghanbari et al rightly conclude that further studies are needed," Rita Redberg, MD, writes in an editorial published with the review.
Redberg, a cardiologist at the University of California, San Francisco and an editor of the Archives of Internal Medicine, sums up the review's findings this way:
"ICDs are being implanted in hundreds of thousands of women without substantial evidence of benefit, apparently based on the assumption that, to paraphrase the old saying, 'What's good for the gander is good for the goose.'"
SOURCES: Marsh, R. Archives of General Psychiatry, January 2009; vol 66: pp 51-63.
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