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Women Less Likely to Get Heart Defibrillators
Date:10/2/2007

nually monitor heart rhythms and deliver electrical shocks to help control erratic rhythms. The devices have been shown to reduce mortality in those at highest risk for sudden cardiac death. Thanks to pivotal trials, Medicare expanded its coverage of ICDs in 2004.

One trial also found that only a small proportion of women who were eligible received an ICD. But that trial, and others, were conducted before the Medicare expansion.

For the first of the new studies, the researchers looked at the medical records of more than 236,000 Medicare patients from 1999 to 2005. The study had two parts -- one looking at primary prevention (those at risk for sudden cardiac death and cardiac arrest) and one looking at secondary prevention (those who had already had cardiac arrest or sudden cardiac death).

Among patients in the primary prevention component, men were 3.2 times more likely than women to receive an ICD. In the secondary prevention trial, men were 2.4 times more likely to receive an ICD.

White men were more likely than black men to get ICDs and white women were more likely than black women to get them.

The gender discrepancy did not appear to narrow over time.

For the second study, the researchers looked at 13,034 patients with heart failure and left ventricular ejection fraction of 30 percent or less (a measure of how well the heart pumps that indicates the risk for sudden cardiac death) between January 2005 and June 2007. Patients had been admitted to one of 217 hospitals participating in the American Heart Association's "Get With the Guidelines" program. This study only looked at primary prevention.

Overall, just 35.4 percent of patients eligible for ICD therapy had received a device by the time of hospital discharge, but the figure varied by group: 28.2 percent of eligible black women received the therapy, along with 29.8 percent of white women, 33.4 percent of black men and 43.6 percent of white m
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