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Article

Sex Specific Outcomes With Cardiac Resynchronization Therapy in Patients With Symptomatic Heart Failure Having Reduced Left Ventricular Ejection Fraction: A Systematic Review and Meta-Analysis

Muhammad Hamayal, MBBS, Muhammad Arham Abbas, MBBS, Momina Hafeez, MBBS, Saira Mahmud, MBBS, Warda Shahid, MBBS, Saman Naeem, MBBS, Hasan Shaukat Abbasi, MBBS, Muhammad Danyal Tahir, MBBS, Aleea Abbas, MBBS, Iqra Iftikhar, MBBS, Naaemah Saleem, MBBS 2025 International Journal of Multidisciplinary Studies and Innovative Researchs

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Abstract

Cardiac resynchronization therapy (CRT) has emerged instrumental in managing heart failure. Notably, there is a lack of evidence of CRT efficacy among both sexes. Thus, this meta-analysis focuses on the long-term benefits of CRT in both sexes. PubMed, The Cochrane Library and clinicaltrials.gov were searched for articles from 2010 to 2024. ROB2 was used to assess risk of bias of RCTs. Newcastle Ottawa Scale was used for quality appraisal of cohorts. Meta-analysis was conducted on Revman 5.4. Out of 2722 articles, only 9 RCTs and 18 cohorts were included. Our results demonstrated that females had a significantly lower risk of composite outcomes compared to males in both RCTs (RR 0.80; 95% CI [0.68, 0.94], P = .006) and cohorts (RR 0.76; 95% CI [0.63, 0.92], P = .004). Results were similar for all-cause mortality. For heart failure hospitalization, only cohorts showed a significant lesser risk in females (RR 0.78; 95% CI [0.65, 0.93], P = .006). Left ventricular ejection fraction improved significantly in females but no differences were observed for NYHA class improvement. Males showed a 31% lower survival rate. However future trials are needed to highlight this variation.

Identifier Metadata

Identifier	110.0189/INT.2026.00164
Canonical	mdoi:110.0189/INT.2026.00164
Resolver URL	https://mdoi.org/110.0189/INT.2026.00164
Resource URL	Open resource
Document URL	Open document
Content Type	Article
Authors	Muhammad Hamayal, MBBS, Muhammad Arham Abbas, MBBS, Momina Hafeez, MBBS, Saira Mahmud, MBBS, Warda Shahid, MBBS, Saman Naeem, MBBS, Hasan Shaukat Abbasi, MBBS, Muhammad Danyal Tahir, MBBS, Aleea Abbas, MBBS, Iqra Iftikhar, MBBS, Naaemah Saleem, MBBS
Year	2025
Depositor	International Journal of Multidisciplinary Studies and Innovative Researchs Organisation
Prefix	110.0189
Registered	June 17, 2026
Updated	June 17, 2026
Status	Active
Visibility	Public

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Sex Specific Outcomes With Cardiac Resynchronization Therapy in Patients With Symptomatic Heart Failure Having Reduced Left Ventricular Ejection Fraction: A Systematic Review and Meta-Analysis

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