Women with heart failure are less likely than men to receive cardiac resynchronization therapy (CRT) -- an implantable device shown to enhance quality of life for people with heart failure; yet women who get CRT live longer than men who get it, according to Mayo Clinic research presented today at the American Heart Association's Scientific Sessions 2005 in Dallas.
The cases of all patients who underwent implantation of a CRT device at Mayo Clinic between 1999 and 2004 were reviewed to determine gender-specific referrals and evaluate how the patients fared with the therapy. A total of 373 patients were included; 82 percent were male. The average age was 69 for men and 65 for women.
Survival at five years for women (76 percent) was almost double that of the men (46 percent).
"Our data highlight a potentially important gender bias, in that fewer women, despite being eligible, are being referred for cardiac resynchronization therapy compared with a similar group of males," says Grace Lin, M.D., the lead author of the study. Dr. Lin practices at Mayo Clinic in Rochester, Minn. "It is another example in recent years of potential under-treatment of women with heart disease in this country. Whether such 'referral bias' is universal, however, deserves further study."
The study also found that device implantation success, complication rates and heart function improvement were similar in men and women. However, benefit of CRT, in terms of long-term survival, was significantly better in women.
"Gender referral bias needs to be addressed by further studies, since women with congestive heart failure who qualify for CRT may have equal or greater benefit than men," Dr. Lin says.
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