Women were significantly less likely than men to have severe LV dysfunction (OR 0.51; 95% CI 0.31-0.84) or previously recognized CAD (OR 0.34; 95% CI 0.20-0.60) prior to sudden cardiac arrest.
Observational (n=1,568)
Does the prevalence of structural heart disease prior to sudden cardiac arrest differ between women and men?
Women who suffer sudden cardiac arrest are significantly less likely than men to have a prior diagnosis of structural heart disease, suggesting they may be less likely to meet current criteria for prophylactic ICD placement.
Odds Ratio: 0.51 (95% CI 0.31–0.84)
Objective Utilization of a community-based approach to identify gender-related differences in risk factors for sudden cardiac arrest (SCA). Background There are significant gender-based differences in prevalence and manifestation of SCA. Any differences related to predictors of SCA in women vs. men are likely to have implications for risk stratification and prevention. Methods The Oregon Sudden Unexpected Death Study is an ongoing prospective investigation of SCA in the Portland, Oregon metropolitan area (pop. 1,000,000). All cases meeting criteria for SCA were ascertained using multiple sources. Medical records were reviewed to identify clinical conditions that may contribute to SCA risk and comparisons made between male and female SCA cases using Pearson’s chi-square tests for categorical variables, t-tests for continuous variables and multivariate logistic regression analysis. Results During 2002-2007, 1568 adult SCA cases were identified (women 36% vs. men 64%; p<0.0001) and women were older (mean age 71±14 vs. 65±14, p<0.0001). There were no significant gender differences in prevalence of obesity, dyslipidemia, history of COPD/asthma, left ventricular (LV) hypertrophy or history of myocardial infarction (MI). In multivariate analysis, women were significantly less likely to have severe LV dysfunction OR 0.51 (0.31 – 0.84) or previously recognized CAD OR 0.34 (0.20 – 0.60) compared to men. Conclusions Women were significantly less likely than men to have a diagnosis of structural heart disease (LV dysfunction or CAD) prior to SCA. These findings suggest that fewer women may be eligible for prophylactic ICD placement based on current guidelines and therefore may not have equal opportunity for prevention. Enhancement of SCA risk stratification may have even higher importance for women.
“Men and women have been treated identically for the prevention of sudden cardiac death. We cannot continue to do that. We need to find novel ways of predicting sudden cardiac death in women because the predictors used so far are more applicable to men.”
Chugh et al. (Sun,) conducted a observational in Sudden cardiac arrest (n=1,568). Female sex vs. Male sex was evaluated on Severe LV dysfunction prior to sudden cardiac arrest (OR 0.51, 95% CI 0.31-0.84). Women were significantly less likely than men to have severe LV dysfunction (OR 0.51; 95% CI 0.31-0.84) or previously recognized CAD (OR 0.34; 95% CI 0.20-0.60) prior to sudden cardiac arrest.