A Conde-Martel1, M E Arkuch2, F Formiga3, L Manzano-Espinosa4, O Aramburu-Bodas5, Á González-Franco6, M F Dávila-Ramos7, I Suárez-Pedreira8, A Herrero-Domingo9, M Montero-Pérez-Barquero10. 1. Servicio de Medicina Interna, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España; Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España. Electronic address: acondemar@telefonica.net. 2. Servicio de Medicina Interna, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España. 3. Servicio de Medicina Interna, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. 4. Unidad de Insuficiencia Cardiaca y Riesgo Vascular, Servicio de Medicina Interna, Hospital Ramón y Cajal, Madrid, España; Universidad de Alcalá, Madrid, España. 5. Servicio de Medicina Interna, Hospital Universitario Virgen de Macarena, Sevilla, España; Universidad de Sevilla, Sevilla, España. 6. Servicio de Medicina Interna, Hospital Universitario Central de Asturias, Oviedo, Asturias, España. 7. Servicio de Medicina Interna, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, España. 8. Servicio de Medicina Interna, Hospital Valle de Nalón, Langreo, Asturias, España. 9. Servicio de Medicina Interna, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo, España. 10. Servicio de Medicina Interna, IMIBIC/Hospital Reina Sofía de Córdoba, Córdoba, España; Universidad de Córdoba, Córdoba, España.
Abstract
HISTORY AND OBJECTIVES: To analyze the differential clinical characteristics according to gender of patients with heart failure in terms of etiology, comorbidity, triggers, treatment, hospital stay and overall mortality at one year. PATIENTS AND METHOD: We employed data from the RICA registry, a multicenter prospective cohort of patients hospitalized in internal medicine departments for heart failure, with a follow-up of one year. We analyzed the differences between the gender in terms of the etiology of the heart disease, comorbidity, triggers, left ventricle ejection fraction, functional state, mental condition, treatment, length of stay and mortality at 1 year. RESULTS: A total of 1772 patients (47.2% men) were included. The women were older than the men (p<.001) and had a higher prevalence of hypertension, obesity, chronic kidney disease, atrial fibrillation and preserved left ventricle ejection fraction (p<.001). The men's medical history had a predominance of myocardial infarction, chronic obstructive pulmonary disease, peripheral arteriopathy (p<.001) and anemia (p=.02). In the women, a hypertensive etiology was predominant, followed by valvular. The main triggers were hypertension and atrial fibrillation. Treatment with beta-blockers, ACEIs and/or ARBs did not differ by sex. The women had poorer functional capacity (p<.001), according to the Barthel index. After adjusting for age and other prognostic factors, the mortality at one year was lower among the women (RR: 0.69; 95% CI 0.53-0.89; p=.004). CONCLUSIONS: HF in women occurs at a later age and with different comorbidities. The hypertensive and valvular etiology is predominant, with preserved left ventricle ejection fraction, and the age-adjusted mortality is lower than in men.
HISTORY AND OBJECTIVES: To analyze the differential clinical characteristics according to gender of patients with heart failure in terms of etiology, comorbidity, triggers, treatment, hospital stay and overall mortality at one year. PATIENTS AND METHOD: We employed data from the RICA registry, a multicenter prospective cohort of patients hospitalized in internal medicine departments for heart failure, with a follow-up of one year. We analyzed the differences between the gender in terms of the etiology of the heart disease, comorbidity, triggers, left ventricle ejection fraction, functional state, mental condition, treatment, length of stay and mortality at 1 year. RESULTS: A total of 1772 patients (47.2% men) were included. The women were older than the men (p<.001) and had a higher prevalence of hypertension, obesity, chronic kidney disease, atrial fibrillation and preserved left ventricle ejection fraction (p<.001). The men's medical history had a predominance of myocardial infarction, chronic obstructive pulmonary disease, peripheral arteriopathy (p<.001) and anemia (p=.02). In the women, a hypertensive etiology was predominant, followed by valvular. The main triggers were hypertension and atrial fibrillation. Treatment with beta-blockers, ACEIs and/or ARBs did not differ by sex. The women had poorer functional capacity (p<.001), according to the Barthel index. After adjusting for age and other prognostic factors, the mortality at one year was lower among the women (RR: 0.69; 95% CI 0.53-0.89; p=.004). CONCLUSIONS: HF in women occurs at a later age and with different comorbidities. The hypertensive and valvular etiology is predominant, with preserved left ventricle ejection fraction, and the age-adjusted mortality is lower than in men.
Authors: Quin E Denfeld; Beth A Habecker; S Albert Camacho; Mary Roberts Davis; Nandita Gupta; Shirin O Hiatt; Mary E Medysky; Jonathan Q Purnell; Kerri Winters-Stone; Christopher S Lee Journal: Circ Heart Fail Date: 2021-08-25 Impact factor: 10.447
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