Sex differences in cardiac arrest survivors

Area of Science:

• Cardiology
• Electrophysiology
• Sex Differences in Medicine

Background:

• Significant sex disparities exist in sudden cardiac death epidemiology and electrophysiological testing outcomes.
• These sex-based differences in cardiac arrest survivors remain poorly understood.

Purpose of the Study:

• To investigate sex differences in underlying pathology and predictors of outcome among cardiac arrest survivors.
• To compare mortality predictors between male and female survivors of out-of-hospital cardiac arrest.

Main Methods:

• Retrospective analysis of 355 consecutive survivors of out-of-hospital cardiac arrest undergoing electrophysiologically guided therapy.
• Assessment of sex differences in underlying cardiac pathology, left ventricular ejection fraction, and inducible arrhythmias.
• Identification of independent predictors of total and cardiac mortality stratified by sex.

Main Results:

• Women had less coronary artery disease (45% vs. 80%) and higher ejection fraction (0.46 vs. 0.41) than men.
• Women were more likely to have no inducible arrhythmia (46% vs. 27%).
• In men, impaired left ventricular ejection fraction (<0.40) predicted mortality; in women, coronary artery disease was the primary predictor.

Conclusions:

• Female cardiac arrest survivors are less likely to have coronary artery disease.
• Mortality predictors significantly differ between male and female survivors.
• Coronary artery disease is the most critical predictor in women; impaired left ventricular function is most critical in men.