Female gender is associated with a worse prognosis amongst patients hospitalised for de‐novo acute heart failure

Abstract

Background Recent evidence showed that new‐onset (de‐novo) acute heart failure (AHF) is a distinct type of AHF. However, the prognostic implication of gender on these patients remains unclear. Aims We aimed to investigate the impact of gender on both short and long‐term mortality outcomes after hospitalisation for de‐novo AHF. Methods We analysed the data of 721 patients with de‐novo AHF, who were enrolled in the HF survey in Israel between March and April 2003 and were followed until December 2014. Results Fifty‐four percent (N = 387) of the patients were men. In comparison to women, men patients were more likely to be younger, smokers, and with ischemic HF aetiology. At 30 days, mortality rates were higher in women (12% vs 7%, P = .013). Survival analysis showed that at 1 and 10 years the all‐cause mortality rates were significantly higher in women (28% vs 17%, and 78% vs 67%, 1 and 10 years, P < .001, respectively). Consistently, multivariable analysis showed that women had an independently 82% and 24% higher mortality risk at 1 and 10 years, respectively, (1‐year hazard ratio = 1.82; 95% confidence interval = 1.07 to 3.11, P = .03; 10‐year hazard ratio = 1.24; 95% confidence interval = 1.03 to 1.48, P = .02). Conclusions Amongst patients with de‐novo AHF, women had higher mortality rates compared with men. The observed gender‐related differences in de‐novo AHF patients highlight the need for further and deeper research in this field.

Scoping Review of Measures of Comorbidities in Heart Failure

“…The studies included in this review were classified into 3 categories based on the purpose of the studies in relation to comorbidities: (1) the relationship between comorbidities and clinical outcomes was the main interest of the study (n = 16, 41.0%), 6,8,[24][25][26][27][28][29][30][31][32][33][34][35][36][37] (2) comorbidities were one of the variables of interest to predict clinical outcomes (n = 12, 30.8%), [38][39][40][41][42][43][44][45][46][47][48][49] and (3) comorbidities were used as a covariate for adjustment when studying the relationship between the variables of interest in the studies and the clinical outcomes (n = 11, 28.2%). [50][51][52][53][54][55][56][57][58][59][60] Other characteristics of the studies in this review are summarized in the Table . The most frequently reported clinical outcomes were mortality (n = 22), hospital admission/readmission (n = 14), quality of life (n = 3), and self-care (n = 4). of comorbidities 6,8,…”

“…6,8,58,60 In 9 studies, the CCI (or its variants) was used for adjustment or as one of the variables of interest to explore the relationship with the clinical outcomes. [42][43][44]49,52,54,56,57,59 Three versions of the CCI were used: the original version, 54,57,59 the revised version, 44 and the age-adjusted version. 49 However, 4 of the 9 studies 42,43,52,56 did not report the specific CCI version they used.…”

“…[42][43][44]49,52,54,56,57,59 Three versions of the CCI were used: the original version, 54,57,59 the revised version, 44 and the age-adjusted version. 49 However, 4 of the 9 studies 42,43,52,56 did not report the specific CCI version they used. In addition, information on the psychometric property of the CCI was not reported in the 9 studies in which the CCI was used.…”

“…In addition, information on the psychometric property of the CCI was not reported in the 9 studies in which the CCI was used. [42][43][44]49,52,54,56,57,59 The relationship between the number of comorbidities and clinical outcomes was explored in 6 studies. 6,8,27,[31][32][33] The number of comorbidities was used in studies where the relationship between comorbidities and clinical outcomes was the main interest.…”

Gender Based Analysis of a Population Series of Patients Hospitalized with Infective Endocarditis in Portugal – How do Women and Men Compare?

“…For the bivariate analysis, the comparison between continuous variables was performed through recognized the need for reducing the gender gap in clinical care and research. 5 Various publications have highlighted the impact of gender on several fields of cardiology such as coronary artery disease [6][7][8] or heart failure, 9,10 as well as in general medicine involving sepsis 11 or pneumonia. 9 Infective endocarditis (IE) constitutes a rare condition with significant morbidity and mortality.…”