Highlights
- •There is conflicting evidence on gender differences in prognosis of acute HF.
- •We investigated gender differences using multiple analytical approaches.
- •Our data strongly suggest that women and men have comparable mortality rates.
Abstract
Background
Still there is conflicting evidence about gender-related differences in prognosis
among patients with heart failure. This prognostic uncertainty may have implications
for risk stratification and planning management strategy. The aim of the present study
was to explore the association between gender and one-year mortality in patients admitted
with acute decompensated heart failure (ADHF).
Methods
We studied 1513 patients. The Cumulative Incidence Function (CIF) method was used
to estimate the absolute rate of mortality, heart transplantation (HT)/ventricular
assist device (VAD) implantation, and survival free of HT/VAD implantation at 1 year. An interaction analysis was performed to assess the association between covariates,
gender, and mortality risk. Propensity score matching and Cox regression were used
to compare mortality rates in the gender subgroups.
Results
The CIF estimates of 1-year mortality, HT/VAD implantation, and survival free of HT/VAD
implantation at 1 year were 33.1%, 7.0%, and 59.9% for women and 30.2%, 10.2%, and 59.6% for men, respectively.
Except for diabetes, there was no significant interaction between gender, covariates,
and mortality risk. In the matched cohort, the hazard ratio of death for women was
1.19 (95% confidence intervals [CIs]: 0.90–1.59; p = .202). After adjusting for age and baseline risk, the hazard ratio of death for women
was 1.18 (95% CIs: 0.95–1.43; p = .127). The use of gender-specific predictive models did not allow improving the accuracy
of risk prediction.
Conclusions
Our data strongly suggest that women and men have comparable outcome in the year following
a hospitalization for ADHF.
Keywords
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Article info
Publication history
Published online: January 06, 2018
Accepted:
January 4,
2018
Received in revised form:
January 2,
2018
Received:
August 4,
2017
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
