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Comparison of morbidity in women versus men with heart failure and preserved ejection fraction.
Am J Cardiol. 2006 Apr 15; 97(8):1228-31.AJ

Abstract

Patients with heart failure (HF) and preserved ejection fraction (HF-PEF) constitute up to 30% to 50% of patients with HF, and HF-PEF affects women more often than men. Not much is known about the role of gender in the clinical presentation, symptoms, or disease severity of HF-PEF or about the contribution of these differences to gender differences in morbidity and mortality in patients with HF-PEF. This study examined gender differences in clinical presentation, hospitalization, and mortality in patients with HF-PEF (ejection fraction > or = 50%) enrolled in the ancillary arm of the Digitalis Investigation Group trial. Time-to-event analysis was performed using Cox proportional-hazards modeling. The study cohort included 719 patients (378 men, 341 women). At baseline, compared with men, women were older and had greater clinical severity of HF, as evidenced by worse New York Heart Association functional class, more frequent symptoms and signs of HF, and more treatment with diuretics. Ischemia was identified as the primary cause of HF in 46% of women and 56% of men (p = 0.01). During a median follow-up of 39 months, crude mortality was similar in women and men (24.6% and 24.3%, p = 0.93), but more women were hospitalized for HF (26.7% vs 15.9%, p <0.001). After adjustment for baseline differences, female gender was an independent predictor of lower mortality (hazard ratio 0.59, 95% confidence interval 0.43 to 0.82), but HF hospitalization rates were similar between men and women (hazard ratio 1.09, 95% confidence interval 0.77 to 1.53). In conclusion, although the clinical manifestations of HF appear to be more severe in women with HF-PEF, after adjustment for baseline clinical differences, HF hospitalizations are not increased and survival expectancy is better for women compared with men.

Authors+Show Affiliations

Winters Center for Heart Failure Research, Section of Cardiology, Department of Medicine, Michael E. DeBakey Veterans Affairs Medical Center & Baylor College of Medicine, Houston, Texas, USA. adeswal@bcm.tmc.eduNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

16616031

Citation

Deswal, Anita, and Biykem Bozkurt. "Comparison of Morbidity in Women Versus Men With Heart Failure and Preserved Ejection Fraction." The American Journal of Cardiology, vol. 97, no. 8, 2006, pp. 1228-31.
Deswal A, Bozkurt B. Comparison of morbidity in women versus men with heart failure and preserved ejection fraction. Am J Cardiol. 2006;97(8):1228-31.
Deswal, A., & Bozkurt, B. (2006). Comparison of morbidity in women versus men with heart failure and preserved ejection fraction. The American Journal of Cardiology, 97(8), 1228-31.
Deswal A, Bozkurt B. Comparison of Morbidity in Women Versus Men With Heart Failure and Preserved Ejection Fraction. Am J Cardiol. 2006 Apr 15;97(8):1228-31. PubMed PMID: 16616031.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of morbidity in women versus men with heart failure and preserved ejection fraction. AU - Deswal,Anita, AU - Bozkurt,Biykem, Y1 - 2006/03/02/ PY - 2005/08/01/received PY - 2005/11/01/revised PY - 2005/11/01/accepted PY - 2006/4/18/pubmed PY - 2006/6/3/medline PY - 2006/4/18/entrez SP - 1228 EP - 31 JF - The American journal of cardiology JO - Am J Cardiol VL - 97 IS - 8 N2 - Patients with heart failure (HF) and preserved ejection fraction (HF-PEF) constitute up to 30% to 50% of patients with HF, and HF-PEF affects women more often than men. Not much is known about the role of gender in the clinical presentation, symptoms, or disease severity of HF-PEF or about the contribution of these differences to gender differences in morbidity and mortality in patients with HF-PEF. This study examined gender differences in clinical presentation, hospitalization, and mortality in patients with HF-PEF (ejection fraction > or = 50%) enrolled in the ancillary arm of the Digitalis Investigation Group trial. Time-to-event analysis was performed using Cox proportional-hazards modeling. The study cohort included 719 patients (378 men, 341 women). At baseline, compared with men, women were older and had greater clinical severity of HF, as evidenced by worse New York Heart Association functional class, more frequent symptoms and signs of HF, and more treatment with diuretics. Ischemia was identified as the primary cause of HF in 46% of women and 56% of men (p = 0.01). During a median follow-up of 39 months, crude mortality was similar in women and men (24.6% and 24.3%, p = 0.93), but more women were hospitalized for HF (26.7% vs 15.9%, p <0.001). After adjustment for baseline differences, female gender was an independent predictor of lower mortality (hazard ratio 0.59, 95% confidence interval 0.43 to 0.82), but HF hospitalization rates were similar between men and women (hazard ratio 1.09, 95% confidence interval 0.77 to 1.53). In conclusion, although the clinical manifestations of HF appear to be more severe in women with HF-PEF, after adjustment for baseline clinical differences, HF hospitalizations are not increased and survival expectancy is better for women compared with men. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/16616031/Comparison_of_morbidity_in_women_versus_men_with_heart_failure_and_preserved_ejection_fraction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(06)00046-4 DB - PRIME DP - Unbound Medicine ER -