Open AccessInfluence of sex and pregnancy on survival in patients admitted with heart failure: Data from a prospective multicenter registry
Author(s) -
MartínezSellés Manuel,
DíezVillanueva Pablo,
Álvarez Garcia Jesús,
FerreroGregori Andreu,
VivesBorrás Miquel,
Worner Fernando,
Bardají Alfredo,
Delgado Juan F.,
Vázquez Rafael,
GonzálezJuanatey José R.,
FernándezAviles Francisco,
Cinca Juan
Publication year - 2018
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22979
Subject(s) - medicine , hazard ratio , confidence interval , gestation , pregnancy , prospective cohort study , ejection fraction , proportional hazards model , heart failure , observational study , obstetrics , survival analysis , gynecology , biology , genetics
Background Female sex is an independent predictor of better survival in patients with heart failure (HF), but the mechanism of this association is unknown. On the other hand, pregnancies have a strong influence on the cardiovascular system. Hypothesis Sex and previous gestations might have a prognostic impact on 1‐year mortality in patients admitted with HF. Methods We conducted an observational, prospective, consecutive, multicenter registry of 1831 patients (756 females [41.2%]) admitted with HF. Results Females had a more advanced age (75.2 ±11.4 vs 70.4 ±12.2 years), less ischemic heart disease (167 [25.3%] vs 446 [47.3%]), and higher left ventricular ejection fraction (52.0% ±16.6% vs 41.1% ±17.0%) than did men (all P values <0.001). During 1‐year follow‐up, 373 (20.4%) patients died (151 females and 222 males). Female sex was an independent predictor for survival (hazard ratio: 0.79, 95% confidence interval: 0.64–0.98, P = 0.03). In 504 women (65.9%), the exact number of previous pregnancies could be determined; 62 women (12.3%) had no previous pregnancies, 288 (57.1%) women had 1 or 2 pregnancies, and 154 women (30.6%) had ≥3 pregnancies. We found an association between the number of previous gestations and better survival (hazard ratio: 0.878, 95% confidence interval: 0.773–0.997, P = 0.045). Conclusions In patients admitted with HF, female sex and the number of previous pregnancies are independently associated with better 1‐year survival.