Influence of Gender on Arrhythmia Characteristics and Outcome in the Multicenter UnSustained Tachycardia Trial
- 26 August 2004
- journal article
- clinical trial
- Published by Wiley in Journal of Cardiovascular Electrophysiology
- Vol. 15 (9), 993-998
- https://doi.org/10.1046/j.1540-8167.2004.04050.x
Abstract
Previous studies have demonstrated gender differences in risk of sudden death in patients with ischemic heart disease. The Multicenter UnSustained Tachycardia Trial (MUSTT) evaluated the ability of therapy guided by electrophysiologic (EP) testing to reduce mortality in patients with coronary disease, ejection fraction < or =40%, and spontaneous nonsustained ventricular tachycardia. We analyzed the influence of gender on results of EP testing and outcome of patients enrolled in MUSTT. Women made up 14% of the overall MUSTT population and were less likely than men to have inducible sustained randomizable ventricular arrhythmias (24% vs 36%, P < 0.001). Baseline characteristics differed between men and women. In randomized patients, women were older, more likely to have had an infarction within 6 months, more likely to have a history of heart failure, and more likely to have recent angina prior to enrollment than men (P < 0.05). In the EP-guided therapy group, there was no difference in implantable cardioverter defibrillator implantation rate in men and women (45% vs 53%, P = 0.38). There also were no significant gender influences on risk of arrhythmic death or cardiac arrest (2-year event rate 9% in women and 12% in men, adjusted hazard ratio 0.88) or overall mortality (2-year event rate 32% in women vs 21% in men, adjusted hazard ratio 1.51). The outcome and benefit of EP-guided therapy in this trial did not appear to be influenced by gender. However, due to the small numbers of women in the trial, small differences in outcome may not be apparent. Plans for future primary prevention trials should include careful risk stratification of women who less often have inducible sustained ventricular arrhythmias and better left ventricular function despite more frequent heart failure.Keywords
This publication has 21 references indexed in Scilit:
- Prophylactic Implantation of a Defibrillator in Patients with Myocardial Infarction and Reduced Ejection FractionNew England Journal of Medicine, 2002
- A Randomized Study of the Prevention of Sudden Death in Patients with Coronary Artery DiseaseNew England Journal of Medicine, 1999
- Gender differences in device therapy for malignant ventricular arrhythmiasArchives of Internal Medicine, 1995
- Prevention of sudden death in patients with coronary artery disease: The multicenter unsustained tachycardia trial (MUSTT)Progress in Cardiovascular Diseases, 1993
- A community-wide perspective of gender differences and temporal trends in the use of diagnostic and revascularization procedures for acute myocardial infarctionThe American Journal of Cardiology, 1993
- Underutilization of thrombolytic therapy in eligible women with acute myocardial infarctionThe American Journal of Cardiology, 1991
- Influence of gender on inducibility of ventricular arrhythmias in survivors of cardiac arrest with coronary artery diseaseThe American Journal of Cardiology, 1991
- Prognostic significance of arrhythmia inducibility or noninducibility at initial electrophysiologic study in survivors of cardiac arrestThe American Journal of Cardiology, 1988
- Determinants of the outcome of electrophysiologic study in patients with ventricular tachyarrhythmiasJournal of the American College of Cardiology, 1985
- Sudden death: Lessons from subsets in population studiesJournal of the American College of Cardiology, 1985