Sex differences in the use of @entity737 for primary and secondary prevention of XXXX .

@entity1 @entity1164 @entity712 @entity296 @entity1165 @entity737 @entity1167 @entity583
CONTEXT: Previous studies of sex differences in the use of @entity737 ( @entity737 ) predate recent expansions in Medicare coverage and did not provide @entity1 follow-up over multiple years. OBJECTIVE: To examine sex differences in ICD use for primary and secondary prevention of @entity1164 . DESIGN, SETTING, AND @entity1 : Analysis of a 5% national sample of research-identifiable files obtained from the US Centers for Medicare _ Medicaid Services for the period 1991 through 2005. @entity1 were those aged 65 years or older with Medicare fee-for-service coverage and diagnosed with @entity583 and either @entity712 or @entity296 but no prior @entity1167 or @entity1165 (ie, the primary prevention cohort [n = 65,917 @entity1 and 70,504 @entity1 ]), or with @entity1167 or @entity1165 (ie, the secondary prevention cohort [n = 52,252 @entity1 and 47,411 @entity1 ]), from 1999 through 2005. MAIN OUTCOME MEASURES: Receipt of ICD therapy and all-cause mortality at 1 year. RESULTS: In the 2005 primary prevention cohort, 32.3 per 1000 @entity1 and 8.6 per 1000 @entity1 received ICD therapy within 1 year of cohort entry. In multivariate analyses, @entity1 were more likely than @entity1 to receive ICD therapy (hazard ratio [HR], 3.15; 95% confidence interval [CI], 2.86-3.47). Among @entity1 and @entity1 alive at 180 days after cohort entry, the hazard of mortality in the subsequent year was not significantly lower among those who received ICD therapy (HR, 1.01; 95% CI, 0.82-1.23). In the 2005 secondary prevention cohort, 102.2 per 1000 @entity1 and 38.4 per 1000 @entity1 received ICD therapy. Controlling for demographic variables and comorbid conditions, @entity1 were more likely than @entity1 to receive ICD therapy (HR, 2.44; 95% CI, 2.30-2.59). Among @entity1 and @entity1 alive at 30 days after cohort entry, the hazard of mortality in the subsequent year was significantly lower among those who received ICD therapy (HR, 0.65; 95% CI, 0.60-0.71). CONCLUSION: In the Medicare population, @entity1 are significantly less likely than @entity1 to receive ICD therapy for primary or secondary prevention of @entity1164 .
