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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, RESULTS. Meshes: Aged, Aged, 80 and over, Cardiomyopathies, Death, Sudden, Cardiac, Defibrillators, Implantable, European Continental Ancestry Group, Female, Health Care Surveys, Humans, Male, Middle Aged, Minority Groups, Women.
user
Are women and minorities less likely to receive an implantable cardioverter defibrillator for primary prevention of sudden cardiac death? Context: Implantable cardioverter defibrillators (ICDs) improve survival in patients with depressed left ventricular ejection fraction (EF). We investigated whether women and minorities are as likely as white men to receive an ICD for primary prevention of sudden cardiac death. We reviewed the electronic medical records of patients with cardiomyopathy by nuclear single-photon emission computed tomography imaging (EF ≤ 35%), who had no prior history of sustained ventricular arrhythmias. Clinical and demographic data were collected and the Charlson comorbidity index (CCI) was calculated for each patient. A total of 233 non-selected patients (age = 68 ± 12 years, 29% women, 21% black, EF 24 ± 6%, CCI 6.62 ± 2.9) were included in this analysis of whom 111 (48%) received an ICD. In univariate analysis, ICD recipients were more likely to be Caucasian men compared with black men or women from all races. After adjusting for race, gender, EF, and the CCI in a multivariate logistic regression model, women were 61% less likely than men [odds ratio (OR) = 0.39, 95% confidence interval (CI) 0.20-0.74, P= 0.004] and blacks were 72% less likely than whites (OR = 0.28, 95% CI 0.13-0.59, P= 0.001) to receive an ICD.
assistant
Even after adjusting for comorbid conditions, gender, and racial discrepancies in the implantation of ICDs for the primary prevention of sudden cardiac death exist. Further investigations into the root causes of these discrepancies are needed before any corrective measures can be adopted. Final Decision: yes