Abstract 17214: Opposing Influence of Gender on the Survival of Patients Admitted with Acute Heart Failure
Introduction: Data on the influence of gender on the prognosis of heart failure (HF) are conflicting possibly due to usage of different endpoints and a heterogeneous heart failure population in prior studies.
Hypothesis: To evaluate whether the conflicting evidence found in the literature arises from differential outcomes between the in-hospital and post discharge periods and the mechanism associated with HF.
Methods: We analyzed the national heart failure survey covering all public hospitals in Israel. The survey included patients admitted with acute heart failure over a two-month period in 2003. All-cause mortality outcomes data were collected for both the in-hospital and the 4-year post-discharge periods.
Results: The study population comprised 2,212 hospitalized HF patients, of whom 45% were women. Women with HF displayed significantly different clinical characteristics than men (all p-values <0.001), including an older age (77.1±9.5 yrs vs. 73.5±10.7 yrs), a higher frequency of HF with preserved ejection fraction (61% vs. 38%), hypertensive heart disease (50% vs. 39%), and a lower percentage of coronary artery disease (62% vs. 79%). Compared with men, women experienced a higher risk of in-hospital mortality, but a lower risk of long-term mortality among those who survived to discharge (Figure: top and bottom panels respectively). The adjusted multivariate proportional-hazards model showed that being female was associated with higher in-hospital mortality (HR, 1.60; 95% CI 1.11-2.30) and lower post-discharge mortality (HR, 0.86; 95% CI, 0.76-0.96).
Conclusions: There are important differences in the etiology and clinical characteristics of men and women hospitalized with HF which may be related to gender differences in the short and long-term survival of this population.
- © 2012 by American Heart Association, Inc.