Heart therapy proves best for women

U. ROCHESTER (US) — A new therapy is significantly more effective—as much as double in some cases—in preventing heart failure in women than in men.

Women who receive cardiac resynchronization therapy with defibrillator (CRT-D) see a 70 percent reduction in heart failure versus 35 percent in men and a 72 percent reduction in death, according to a new study published in the Journal of the American College of Cardiology.

“In prior cardiac studies, men and women generally received similar benefit from preventive medical therapy,” says cardiologist Arthur J. Moss, professor of medicine at the University of Rochester and lead author of the study.

“Our finding was unexpected, but extremely important because this is the only heart treatment that is clearly better in women than men.”

In women with mild heart failure, CRT-D therapy effectively prevented deterioration of the heart, otherwise known as cardiac remodeling, by preventing enlargement of the heart with more effective contraction of the heart.

Women in the study were more likely to have non-ischemic heart disease, a disorder typically characterized by inflammatory scarring of the heart muscle, while men had a greater likelihood of ischemic heart disease, otherwise known as coronary artery disease – where narrowed arteries restrict the flow of blood and oxygen to the heart.

Additionally, more women had left bundle branch block, a condition that results in disorganized electrical activity throughout the heart.

Because left bundle branch block and non-ischemic heart disease lead to diffuse, as opposed to localized, heart problems, researchers reasoned women were more responsive to CRT-D therapy, a treatment that strengthens the overall mechanical pumping action of the heart and coordinates the heart’s electrical activity.

“It’s not that men did poorly in the trial, but rather, women had really fantastic results, likely due to they type of heart disease we see more commonly in women,” notes Moss.

The CRT-D device, developed by Boston Scientific, was originally approved to treat patients with severe heart failure.

In September 2010, the Food and Drug Administration extended the approval of the Boston Scientific device to patients with mild heart failure to prevent progression to advanced heart failure. With the new indication, nearly 4 million more Americans are candidates for treatment with the CRT-D.

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