No sex-related differences in all-cause mortality risk after acute HF admission
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New data published in the Journal of the American Heart Association found no sex-related differences in all-cause mortality after acute HF hospitalization.
“Different studies have consistently shown that men are predisposed to HF with reduced ejection fraction, whereas women are more affected by HF with preserved ejection fraction,” Enrique Santas, MD, PhD, cardiologist at the Clinical Hospital at the University of València, València, Spain, and colleagues wrote. “Women are more symptomatic and display poorer quality of life than men in both conditions. In contrast, different studies have reported a better prognosis for women with HF.”
The retrospective analysis evaluated a multicenter prospective registry of 4,812 patients (mean age, 74 years; 47% women) from three hospitals in Spain who were consecutively admitted to hospital for acute HF from January 2008 to October 2019. During index hospitalization, researchers performed a 2-dimensional transthoracic echocardiogram in all patients.
The primary outcome was all-cause, CV and HF-related mortality at 6 months.
In total, 54.2% of patients had left ventricular EF 50% or less. At 6 months, 13.4% of patients died, with a mortality rate of 13.3% among women and 13.5% among men (P = .822). Among the cohort, 11.3% experienced CV-related death and 8.6% experienced HF-related death. Researchers found that LVEF was not independently associated with mortality (HR = 1.02; 95% CI, 0.99-1.05; P = .135).
There were no sex-related differences in all-cause mortality (P = .168) following multivariable adjustment analyses. In addition, researchers observed a significant interaction between sex and CV-related (P = .03) and HF-related (P = .007) mortality risks across LVEF.
Women demonstrated significantly lower risks for CV-related mortality at LVEF < 25% and for HF-related mortality at LVEF < 43% compared with men. However, there was a higher HF-related mortality risk at the upper extreme of LVEF (> 80%) among women compared with men.
“Future studies should confirm these findings and evaluate the potential negative implications of a supranormal LVEF in women with HFpEF,” the researchers wrote.
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