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Sex‐specific acute heart failure phenotypes and outcomes from PROTECT
Author(s) -
Meyer Sven,
Meer Peter,
Massie Barry M.,
O'Connor Christopher M.,
Metra Marco,
Ponikowski Piotr,
Teerlink John R.,
Cotter Gad,
Davison Beth A.,
Cleland John G.F.,
Givertz Michael M.,
Bloomfield Daniel M.,
Fiuzat Mona,
Dittrich Howard C.,
Hillege Hans L.,
Voors Adriaan A.
Publication year - 2013
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hft115
Subject(s) - medicine , heart failure , hazard ratio , blood pressure , ejection fraction , diabetes mellitus , body mass index , population , blood urea nitrogen , cardiology , renal function , confidence interval , heart failure with preserved ejection fraction , diuretic , endocrinology , environmental health
Aims Differences in manifestation, treatment, and outcomes of acute heart failure between men and women have not been well studied. The objective of this analysis was to characterize differences in clinical presentation, and in‐hospital and post‐discharge outcomes between sexes in acute heart failure patients. Methods and results Clinical profiles, treatment characteristics, and outcomes were compared between sexes in 2033 patients hospitalized for acute heart failure and impaired renal function. Women comprised 33% of the study population and were older, had higher body mass index, LVEF, and systolic blood pressure, and a greater prevalence of diabetes. At baseline, women showed signs and symptoms of congestion comparable with men, but more often had rales, orthopnoea, and worse renal function. Women were less intensively diuresed, as indicated by lower oral and intravenous diuretic doses used, fewer dose increases, and less total weight loss during hospitalization. Furthermore, hospitalization was slightly but significantly prolonged in women (11.04 ± 7.8 vs. 10.65 ± 8.86 days; P = 0.024). Age‐adjusted 180‐day mortality was lower in women (15.8% vs. 18.5%, hazard ratio 0.74; 95% confidence interval 0.59–0.93, P = 0.010), but multivariable risk‐adjusted mortality was similar in both sexes, mainly attributable to lower blood urea nitrogen, higher LVEF, and higher systolic blood pressure in women compared with men. Conclusions Women with acute heart failure present with a clinical profile different from that of men, with more hypertension, diabetes, and depression, and a preserved LVEF. During hospitalization, they were less intensively diuresed. Nevertheless, risk‐adjusted 180‐day outcome was similar between sexes.