Sex disparities in cardiac sarcoidosis patients undergoing implantable cardioverter-defibrillator implantation.

Abstract

In patients with cardiac sarcoidosis (CS), implantable cardioverter-defibrillators (ICDs) are important for preventing sudden cardiac death. This study aimed to investigate sex disparities in CS patients undergoing ICD implantation. The 2016-2020 National Inpatient Sample (NIS) database compared the characteristics and outcomes of males and females with CS receiving ICDs. Among 760 CS patients who underwent inpatient ICD implantation, 66.4% were male. Males were younger (55.0vs. 56.9 years, p<.01), had higher rates of diabetes (31.7%vs. 21.6%, p<.01) and chronic kidney disease (CKD) (16.8%vs. 7.8%, p<.01) but lower prevalence of atrial fibrillation (AF) (11.9%vs. 23.5%, p<.01), sick sinus syndrome (4.0%vs. 7.8%, p=.024), ventricular fibrillation (VF) (9.9%vs. 15.7%, p=.02), and black ancestry (31.9%vs. 58.0%, p<.01). Unadjusted major adverse cardiovascular events (MACE), defined as a composite of in-hospital death, myocardial infarction (MI), and ischemic stroke, was higher in females (11.8%vs. 6.9%, p=.024), but when adjusted for age and tCharlson Comorbidity Index (CCI), females demonstrated significantly lower odds of experiencing MACE (aOR: 0.048, 95% CI: 0.006-0.395, p=.005). Incidence of acute kidney injury (AKI) post-ICD was significantly lower in females (15.7%vs. 23.8%, p=.01) as was the adjusted odds (aOR: 0.282, 95% CI: 0.146-0.546, p<.01). There was comparable mean length of stay and hospital charges. ICD utilization in CS patients is more common among males, who have a higher prevalence of diabetes and CKD but a lower prevalence of AF, sick sinus syndrome, and VF. Adjusted MACE and AKI were significantly lower in females.