Women receive greater benefit from
CRT-Ds than men
14 July 2010
Cardiac resynchronization therapy defibrillators (CRT-Ds)
reduce heart failure events more in women than men, according to data
from Boston Scientific Corporation's MADIT-CRT trial.
The results demonstrated that both men and women experienced
significant benefit from cardiac resynchronization therapy. However,
women experienced a 70% reduction in heart failure events compared
to a 35% reduction for men. Additional analysis demonstrated that
women with asymptomatic or mild heart failure experienced a 72%
reduction in all-cause mortality.
"There are a number of factors that may explain why women
experienced a greater benefit than men," said Arthur Moss, M.D.,
Professor of Medicine at the University of Rochester Medical Center
and Principal Investigator of the MADIT-CRT trial.
"CRT-D therapy is designed to improve the heart's overall pumping
ability and women are more likely than men to have non-ischemic
heart disease, which typically affects the entire heart rather than
a single region and can lead to reduced pumping strength, abnormal
heart rhythms and disturbances in the heart's electrical system. Men
are more likely to have ischemic heart disease, also known as
coronary artery disease, which often leads to a more localized
impact on the heart."
"These findings are noteworthy because CRT-D therapy has
historically been underutilized in women compared to men with the
same level of heart disease," said Kenneth Stein, M.D., Chief
Medical Officer, CRM, for Boston Scientific's Cardiology, Rhythm and
"Boston Scientific believes that all patients should have equal
access to high-quality cardiovascular care regardless of gender. We
believe these findings will help reduce treatment disparities
between men and women."
MADIT-CRT is the world's largest randomized CRT-D study of New
York Heart Association (NYHA) Class I and II patients, with more
than 1,800 patients enrolled at 110 centres worldwide. Results of
the MADIT-CRT trial were published in the October 2009 issue of the
New England Journal of Medicine. Boston Scientific
currently has an application under review with the U.S. Food and
Drug Administration for the expansion of its CRT-D indication to
include high-risk NYHA Class I and II patients with Left Bundle