Justina Motiejūnaitė1,2,3, Eiichi Akiyama1,4, Alain Cohen-Solal1,5,6, Aldo Pietro Maggioni7, Christian Mueller8, Dong-Ju Choi9, Aušra Kavoliūnienė3, Jelena Čelutkienė10, Jiri Parenica11, Johan Lassus12, Katsuya Kajimoto13, Naoki Sato14, Òscar Miró15,16, W Frank Peacock17, Yuya Matsue18,19, Adriaan A Voors20, Carolyn S P Lam20,21,22, Justin A Ezekowitz23, Ali Ahmed24, Gregg C Fonarow25, Etienne Gayat1,2,6, Vera Regitz-Zagrosek26, Alexandre Mebazaa1,2,6. 1. Inserm UMR-S 942 MASCOT, Hôpital Lariboisière - Bâtiment Viggo Petersen 41, boulevard de la Chapelle, 75475 Paris Cedex 10, France. 2. Department of Anesthesiology and Critical Care, Hôpitaux Universitaires Saint Louis-Lariboisière, Assistance Publique des Hôpitaux de Paris, 2 Rue Ambroise Paré, 75010 Paris, France. 3. Department of Cardiology, Lithuanian University of Health Sciences Kaunas Clinics, 2 Eivenių street 2 LT-50009 Kaunas, Lithuania. 4. Division of Cardiology, Yokohama City University Medical Center, 4 Chome-57, 〒 232-0024 Kanagawa, Yokohama, Minami Ward, Urafunecho, Japan. 5. Department of Cardiology, Hôpitaux Universitaires Saint Louis-Lariboisière, Assistance Publique des Hôpitaux de Paris, 2 Rue Ambroise Paré, 75010 Paris, France. 6. Université de Paris, 16 Rue Henri Huchard, 75018 Paris, France. 7. ANMCO Research Center, Via Alfonso la Marmora, 36, 50121 Firenze FI, Italy. 8. Department of Cardiology, Cardiovascular Research Institute Basel, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland. 9. Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, 101 Daehak-Ro, Jongno-gu, Seoul 03080, South Korea. 10. Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Vilnius University, 2 Santariskiu Street, LT-08661 Bilnius, Lithuania. 11. Department of Cardiology, University Hospital Brno and Medical Faculty, Masaryk University, Kamenice 5, 625 00 Bohunice, Czech Republic. 12. Cardiology, Division of Cardiology, Heart and Lung Center, Helsinki University Hospital, Helsinki University, Haartmaninkatu 4 Rakennus 1, 00290 Helsinki, Finland. 13. Division of Cardiology, Sekikawa Hospital, 1 Chome-4-1 Nishinippori, Arakawa City, Tokyo 116-0013, Japan. 14. Division of Cardiology and Intensive Care Unit, Nippon Medical School Musashi-Kosugi Hospital, 1 Chome-396 Kosugimachi, Nakahara Ward, Kawasaki, Kanagawa 211-8533, Japan. 15. Emergency Department, Hospital Clinic and "Emergencies: Processes and Pathologies" Research Group, IDIBAPS, Carrer del Rosselló, 149, 08036 Barcelona, Spain. 16. University of Barcelona, Gran Via de les Corts Catalanes, 585 08007 Barcelona, Spain. 17. Emergency Department, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA. 18. Department of Cardiovascular Medicine, Juntendo University, 3 Chome-1-3 Hongo, Bunkyo City, Tokyo 113-8431, Japan. 19. Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, 3 Chome-1-3 Hongo, Bunkyo City, Tokyo 113-8431, Japan. 20. Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands. 21. National Heart Centre, 5 Hospital Dr, Singapore 169609, Singapore. 22. Duke-National University of Singapore, 8 College Rd, Singapore 169857, Singapore. 23. Canadian VIGOUR Centre, Katz Group Centre for Pharmacy and Health Research, University of Alberta, 4-120, Edmonton, AB T6G, Canada. 24. Department of Medicine, Center for Health and Aging, Veterans Affairs Medical Center, George Washington University, 2121 I St NW, Washington, DC 20052, USA. 25. Division of Cardiology, Department of Medicine, University of California, Los Angeles, 100 Medical Plaza Driveway, Los Angeles, CA 90095, USA. 26. Center for Gender in Medicine (GIM), Center for Cardiovascular Research, (CCR), Charite - Universitaetsmedizin Berlin, DZHK Partner Site Berlin, Charitépl. 1, 10117 Berlin, Germany.
Abstract
AIMS: Recent data from national registries suggest that acute heart failure (AHF) outcomes might vary in men and women, however, it is not known whether this observation is universal. The aim of this study was to evaluate the association of biological sex and 1-year all-cause mortality in patients with AHF in various regions of the world. METHODS AND RESULTS: We analysed several AHF cohorts including GREAT registry (22 523 patients, mostly from Europe and Asia) and OPTIMIZE-HF (26 376 patients from the USA). Clinical characteristics and medication use at discharge were collected. Hazard ratios (HRs) for 1-year mortality according to biological sex were calculated using a Cox proportional hazards regression model with adjustment for baseline characteristics (e.g. age, comorbidities, clinical and laboratory parameters at admission, left ventricular ejection fraction). In the GREAT registry, women had a lower risk of death in the year following AHF [HR 0.86 (0.79-0.94), P < 0.001 after adjustment]. This was mostly driven by northeast Asia [n = 9135, HR 0.76 (0.67-0.87), P < 0.001], while no significant differences were seen in other countries. In the OPTIMIZE-HF registry, women also had a lower risk of 1-year death [HR 0.93 (0.89-0.97), P < 0.001]. In the GREAT registry, women were less often prescribed with a combination of angiotensin-converting enzyme inhibitors and beta-blockers at discharge (50% vs. 57%, P = 0.001). CONCLUSION: Globally women with AHF have a lower 1-year mortality and less evidenced-based treatment than men. Differences among countries need further investigation. Our findings merit consideration when designing future global clinical trials in AHF. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Recent data from national registries suggest that acute heart failure (AHF) outcomes might vary in men and women, however, it is not known whether this observation is universal. The aim of this study was to evaluate the association of biological sex and 1-year all-cause mortality in patients with AHF in various regions of the world. METHODS AND RESULTS: We analysed several AHF cohorts including GREAT registry (22 523 patients, mostly from Europe and Asia) and OPTIMIZE-HF (26 376 patients from the USA). Clinical characteristics and medication use at discharge were collected. Hazard ratios (HRs) for 1-year mortality according to biological sex were calculated using a Cox proportional hazards regression model with adjustment for baseline characteristics (e.g. age, comorbidities, clinical and laboratory parameters at admission, left ventricular ejection fraction). In the GREAT registry, women had a lower risk of death in the year following AHF [HR 0.86 (0.79-0.94), P < 0.001 after adjustment]. This was mostly driven by northeast Asia [n = 9135, HR 0.76 (0.67-0.87), P < 0.001], while no significant differences were seen in other countries. In the OPTIMIZE-HF registry, women also had a lower risk of 1-year death [HR 0.93 (0.89-0.97), P < 0.001]. In the GREAT registry, women were less often prescribed with a combination of angiotensin-converting enzyme inhibitors and beta-blockers at discharge (50% vs. 57%, P = 0.001). CONCLUSION: Globally women with AHF have a lower 1-year mortality and less evidenced-based treatment than men. Differences among countries need further investigation. Our findings merit consideration when designing future global clinical trials in AHF. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Pascal M Mutie; Hugo Pomares-Milan; Naeimeh Atabaki-Pasdar; Daniel Coral; Hugo Fitipaldi; Neli Tsereteli; Juan Fernandez Tajes; Paul W Franks; Giuseppe N Giordano Journal: Diabetologia Date: 2022-10-12 Impact factor: 10.460
Authors: Enrique Santas; Patricia Palau; Pau Llácer; Rafael de la Espriella; Gema Miñana; Gonzalo Núñez-Marín; Miguel Lorenzo; Raquel Heredia; Juan Sanchis; Francisco Javier Chorro; Antoni Bayés-Genís; Julio Núñez Journal: J Am Heart Assoc Date: 2021-12-20 Impact factor: 6.106