Jaehoon Chung1,2, Hack-Lyoung Kim2, Myung-A Kim2, Dong-Ju Choi3, Seongwoo Han4, Eun-Seok Jeon5, Myeong-Chan Cho6, Jae-Joong Kim7, Byung-Su Yoo8, Mi-Seung Shin9, Seok-Min Kang10, Shung Chull Chae11, Kyu-Hyung Ryu4. 1. Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea. 2. Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea. 3. Department of Internal Medicine, Seoul National University College of Medicine, Bundang Hospital, Seongnam, Republic of Korea. 4. Department of Cardiovascular Medicine, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwasung, Republic of Korea. 5. Department of Internal Medicine, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea. 6. Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea. 7. Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. 8. Department of Internal Medicine, Yonsei University Wonju Christian Hospital, Wonju, Republic of Korea. 9. Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea. 10. Department of Internal Medicine, Yonsei University Severance Hospital, Seoul, Republic of Korea. 11. Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Republic of Korea.
Abstract
Background: Although a better survival rate in women than in men has been reported in heart failure (HF) with reduced ejection fraction (HFrEF), the sex-specific prognosis has scarcely been addressed in HF with preserved EF (HFpEF). Thus, this study investigated the sex difference in clinical outcomes in patients with HFpEF, as well as in those with HFrEF. Materials and Methods: We studied clinical outcomes of 2,572 hospitalized patients due to HF (66.8 ± 14.4 years, 49.7% women) in the Korean Heart Failure Registry. Patients were divided into two groups by left ventricular EF (LVEF): HFpEF (LVEF ≥50%, n = 764) and HFrEF (LVEF <40%, n = 1,808) groups. Results: During a median follow-up of 1,121 days, there were 693 (28.7%) deaths and 1,073 (44.5%) composite events (death and HF readmission). There were no sex differences in the incidence of death or composite events during follow-up in both HFrEF and HFpEF groups (p > 0.05 for each). In 1:1 age-matched population (n = 1,005 in each sex), the long-term mortality was significantly lower in women than men in HFrEF group (p = 0.005), but not in HFpEF group (p = 0.786), while the incidences of composite events were similar between sex irrespective of LVEF (p > 0.05). However, there were no significant associations between sex and clinical outcomes in multivariable analysis (p > 0.05 for each). Conclusions: Sex per se was not the significant factor determining long-term clinical outcomes in HF patients regardless of the LVEF.
Background: Although a better survival rate in women than in men has been reported in heart failure (HF) with reduced ejection fraction (HFrEF), the sex-specific prognosis has scarcely been addressed in HF with preserved EF (HFpEF). Thus, this study investigated the sex difference in clinical outcomes in patients with HFpEF, as well as in those with HFrEF. Materials and Methods: We studied clinical outcomes of 2,572 hospitalized patients due to HF (66.8 ± 14.4 years, 49.7% women) in the Korean Heart Failure Registry. Patients were divided into two groups by left ventricular EF (LVEF): HFpEF (LVEF ≥50%, n = 764) and HFrEF (LVEF <40%, n = 1,808) groups. Results: During a median follow-up of 1,121 days, there were 693 (28.7%) deaths and 1,073 (44.5%) composite events (death and HF readmission). There were no sex differences in the incidence of death or composite events during follow-up in both HFrEF and HFpEF groups (p > 0.05 for each). In 1:1 age-matched population (n = 1,005 in each sex), the long-term mortality was significantly lower in women than men in HFrEF group (p = 0.005), but not in HFpEF group (p = 0.786), while the incidences of composite events were similar between sex irrespective of LVEF (p > 0.05). However, there were no significant associations between sex and clinical outcomes in multivariable analysis (p > 0.05 for each). Conclusions: Sex per se was not the significant factor determining long-term clinical outcomes in HF patients regardless of the LVEF.
Entities:
Keywords:
ejection fraction; heart failure; prognosis; sex
Authors: Caroline Espersen; Ross T Campbell; Brian Claggett; Eldrin F Lewis; John D Groarke; Kieran F Docherty; Matthew M Y Lee; Moritz Lindner; Tor Biering-Sørensen; Scott D Solomon; John J V McMurray; Elke Platz Journal: ESC Heart Fail Date: 2021-03-11