Abstract
Background
Current data on the influence of sex on the prognosis of heart failure (HF) are conflicting,
possibly owing to the use of different end points and a heterogeneous heart failure
population in earlier studies. We sought to evaluate the effect of sex on the risk
of early and late mortality outcomes after hospitalization for acute heart failure.
Methods and Results
The prospective cohort study population comprised 2,212 hospitalized patients with
acute HF enrolled in a multicenter national survey in Israel. Cox proportional-hazards
regression modeling was used to evaluate the effect of sex on the risk of early (≤6
months) and late (>6 months to 4 years) mortality after the index hospitalization.
Among the study patients, 998 (45%) were women. Women with HF displayed significantly
different clinical characteristics compared with men, including older age, higher
frequency of HF with preserved ejection fraction and hypertensive heart disease, and
lower percentage of coronary artery disease (all P < .001). The fully adjusted multivariable analyses for mortality outcomes showed
that women tended toward an increased risk for early (≤6 months) mortality (hazard
ratio [HR] 1.16, 95% confidence interval [CI] 0.96–1.41; P = .13), whereas men had significantly increased risk for late (>6 months) mortality
(HR 1.25, 95% CI 1.09–1.43; P = .001).
Conclusions
There are important differences in the clinical characteristics and the short- and
long-term outcomes between men and women hospitalized with acute HF after adjusting
for multiple confounding variables.
Key Words
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Article info
Publication history
Published online: December 27, 2013
Accepted:
December 18,
2013
Received in revised form:
December 15,
2013
Received:
February 24,
2013
Footnotes
The first 2 authors contributed equally to this work.
See page 197 for disclosure information.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
