Evidence map›Paper›PMID 27618617›Full record

SynthesisPloS one2016

Gender Differences in Appropriate Shocks and Mortality among Patients with Primary Prophylactic Implantable Cardioverter-Defibrillators: Systematic Review and Meta-Analysis.

David Conen, Barbora Arendacká, Christian Röver, Leonard Bergau, Pascal Munoz, Sofieke Wijers, Christian Sticherling, Markus Zabel, Tim Friede

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Sex-specific trends in ventricular arrhythmias among European implantable cardioverter-defibrillator recipients.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  4. Article
  5. Article
  6. Review
  7. Incidence and risk factors for first and recurrent ICD shock therapy in patients with an implantable cardioverter defibrillator.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
    Article
  8. Sex differences among subcutaneous implantable cardioverter-defibrillator recipients: a propensity-matched, multicentre, international analysis from the i-SUSI project.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Observational
  9. Article
  10. Article
  11. Article
  12. Article
  13. Underrepresentation of women in implantable cardioverter defibrillator trials.American heart journal plus : cardiology research and practice · 2022
    Article
  14. Review
  15. European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on risk assessment in cardiac arrhythmias: use the right tool for the right outcome, in the right population.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2020
    Article
  16. Review
  17. Observational
  18. Observational
  19. Sex differences in outcomes of primary prevention implantable cardioverter-defibrillator therapy: combined registry data from eleven European countries.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2018
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 3 countries.

David ConenDivision of Internal Medicine, Department of Medicine, University Hospital Basel, Basel, Switzerland.
Barbora ArendackáDepartment of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.
Christian RöverDepartment of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.
Leonard BergauDepartment of Cardiology and Pulmonology and Clinical Electrophysiology Division, University Medical Center Göttingen, Göttingen, Germany.
Pascal MunozDepartment of Cardiology and Pulmonology and Clinical Electrophysiology Division, University Medical Center Göttingen, Göttingen, Germany.
Sofieke WijersDepartment of Physiology and Cardiology, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands.
Christian SticherlingDivision of Cardiology, Department of Medicine, University Hospital Basel, Basel, Switzerland.
Markus ZabelDepartment of Cardiology and Pulmonology and Clinical Electrophysiology Division, University Medical Center Göttingen, Göttingen, Germany.
Tim FriedeDepartment of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.
Universitätsmedizin Göttingen · DEUniversity Hospital of Basel · CHGerman Centre for Cardiovascular Research · DEUniversity Medical Center Utrecht · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSome but not all prior studies have shown that women receiving a primary prophylactic implantable cardioverter defibrillator (ICD) have a lower risk of death and appropriate shocks than men. PURPOSE: To evaluate the effect of gender on the risk of appropriate shock, all-cause mortality and inappropriate shock in contemporary studies of patients receiving a primary prophylactic ICD. DATA SOURCE: PubMed, LIVIVO, Cochrane CENTRAL between 2010 and 2016. STUDY SELECTION: Studies providing at least 1 gender-specific risk estimate for the outcomes of interest. DATA EXTRACTION: Abstracts were screened independently for potentially eligible studies for inclusion. Thereby each abstract was reviewed by at least two authors. DATA SYNTHESIS: Out of 680 abstracts retained by our search strategy, 20 studies including 46'657 patients had gender-specific information on at least one of the relevant endpoints. Mean age across the individual studies varied between 58 and 69 years. The proportion of women enrolled ranged from 10% to 30%. Across 6 available studies, women had a significantly lower risk of first appropriate shock compared with men (pooled multivariable adjusted hazard ratio 0.62 (95% CI [0.44; 0.88]). Across 14 studies reporting multivariable adjusted gender-specific hazard ratio estimates for all-cause mortality, women had a lower risk of death than men (pooled hazard ratio 0.75 (95% CI [0.66; 0.86]). There was no statistically significant difference for the incidence of first inappropriate shocks (3 studies, pooled hazard ratio 0.99 (95% CI [0.56; 1.73]). LIMITATIONS: Individual patient data were not available for most studies.

conclusionIn this large contemporary meta-analysis, women had a significantly lower risk of appropriate shocks and death than men, but a similar risk of inappropriate shocks. These data may help to select patients who benefit from primary prophylactic ICD implantation.

Indexed as

Defibrillators, ImplantableFemaleHumansMaleSex Factors

Identifiers

PMID27618617
PMCPMC5019464
OpenAlexW2520051525

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.