Women clear winners with heart failure device

For women with mild heart failure, device therapy is an extremely attractive option to prevent progression of the disease, according to a study presented today at the Heart Rhythm Society's 31st Annual Scientific Sessions. Women with mild heart disease who had a cardiac resynchronization device combined with a defibrillator (CRT-D) implanted had a 70 percent reduction in heart failure alone and a 72 percent reduction in death from any cause. Men received some benefit from the therapy, but not the out-of-the-park results seen in women.

"This is the first study in which a heart failure therapy has proven more effective in women than in men," said cardiologist Arthur Moss, M.D., professor of Medicine at the University of Rochester Medical Center and lead author of the study.

The study is a sub-analysis of the MADIT-CRT trial, which was published last year in the New England Journal of Medicine. Researchers found that females receiving CRT-D therapy to prevent heart failure progression had significantly better outcomes than males receiving the therapy. Reduction of heart failure in females was twice that of males – 70 percent versus 35 percent. While women saw a significant 72 percent reduction in death from any cause, there was no evident reduction in men.

This gender-based analysis comes less than two months after an advisory panel to the U.S. Food and Drug Administration recommended that the device, which is developed by Boston Scientific, be approved for use in patients with mild heart failure. The device is already approved to treat patients with severe heart failure. If approved for the new prevention of heart failure indication, nearly 4 million more Americans could be candidates for treatment with the CRT-D.

"Anecdotally, we know that women are offered devices to treat heart failure less often than men," said Wojciech Zareba, M.D., Ph.D., professor of Medicine at the University of Rochester Medical Center and co-author of the study. "We're hopeful that these results will change the mindset of physicians and that they will apply this type of therapy as indicated in women as well as in men."

Currently, 42 million American women are living with heart disease. It is the leading killer of women in the United States, each year claiming more women than men. In 2005, cardiovascular disease claimed the lives of more than 450,000 women, while all forms of cancer claimed the lives of approximately 265,000 women, according to the American Heart Association.

In women with mild heart failure, CRT-D therapy effectively prevented deterioration of the heart, otherwise known as cardiac remodeling. While "remodeling" typically has positive connotations – think new kitchen with updated appliances, sparkling marble countertops and refurbished floors – cardiac remodeling is actually an unwanted consequence of a damaged heart (from a heart attack or an infection) that is marked by enlargement of the heart.