TY - JOUR
T1 - Gender-related dissociation in outcomes in chronic heart failure
T2 - Reduced mortality but similar hospitalization in women
AU - Ahmed, Mustafa I.
AU - Lainscak, Mitja
AU - Mujib, Marjan
AU - Love, Thomas E.
AU - Aban, Inmaculada
AU - Piña, Ileana L.
AU - Aronow, Wilbert S.
AU - Bittner, Vera
AU - Ahmed, Ali
N1 - Funding Information:
Dr. Ahmed is supported by the National Institutes of Health through grants ( R01-HL085561 and R01-HL097047 ) from the National Heart, Lung, and Blood Institute and a generous gift from Ms. Jean B. Morris of Birmingham, Alabama.
PY - 2011/4/1
Y1 - 2011/4/1
N2 - Background: The impact of gender on major natural history endpoints in heart failure (HF) has not been examined in a propensity-matched study. Methods: Of the 7788 chronic systolic and diastolic HF patients in the Digitalis Investigation Group trial 1926 were women. Propensity scores for female gender were used to assemble a cohort of 1669 pairs of men and women who were well-balanced on 32 measured baseline characteristics. Matched hazard ratios (HR) and 95% confidence intervals (CI) for outcomes associated with female gender were calculated using stratified Cox regression models. Results: All-cause mortality occurred in 36% (rate, 1256/10,000 person-years) and 30% (rate, 1008/10,000 person-years) of matched men and women respectively during 5 years of follow up (HR when women were compared with men, 0.82, 95% CI, 0.72-0.94, P = 0.004). Female gender was also associated with reduced cardiovascular mortality (matched HR, 0.85; 95% CI, 0.73-0.99, P = 0.037) and a trend toward reduced non-cardiovascular mortality (matched HR, 0.73; 95% CI, 0.53-1.00; P = 0.053). All-cause hospitalization occurred in 67% (rate, 4003/10,000 person-years) and 65% (rate, 3762/10,000 person-years) matched male and female patients respectively (HR for women, 1.03, 95% CI, 0.93-1.15, P = 0.538). Female gender was not associated with cardiovascular or HF hospitalization but was associated with hospitalization due to unstable angina pectoris (matched HR, 1.38; 95%CI, 1.11-1.72; P = 0.003) and stroke (matched HR, 0.65; 95%CI, 0.46-0.92; P = 0.014). Conclusions: In patients with chronic HF, female gender has a significant independent association with improved survival but has no association with all-cause, cardiovascular, or HF hospitalizations.
AB - Background: The impact of gender on major natural history endpoints in heart failure (HF) has not been examined in a propensity-matched study. Methods: Of the 7788 chronic systolic and diastolic HF patients in the Digitalis Investigation Group trial 1926 were women. Propensity scores for female gender were used to assemble a cohort of 1669 pairs of men and women who were well-balanced on 32 measured baseline characteristics. Matched hazard ratios (HR) and 95% confidence intervals (CI) for outcomes associated with female gender were calculated using stratified Cox regression models. Results: All-cause mortality occurred in 36% (rate, 1256/10,000 person-years) and 30% (rate, 1008/10,000 person-years) of matched men and women respectively during 5 years of follow up (HR when women were compared with men, 0.82, 95% CI, 0.72-0.94, P = 0.004). Female gender was also associated with reduced cardiovascular mortality (matched HR, 0.85; 95% CI, 0.73-0.99, P = 0.037) and a trend toward reduced non-cardiovascular mortality (matched HR, 0.73; 95% CI, 0.53-1.00; P = 0.053). All-cause hospitalization occurred in 67% (rate, 4003/10,000 person-years) and 65% (rate, 3762/10,000 person-years) matched male and female patients respectively (HR for women, 1.03, 95% CI, 0.93-1.15, P = 0.538). Female gender was not associated with cardiovascular or HF hospitalization but was associated with hospitalization due to unstable angina pectoris (matched HR, 1.38; 95%CI, 1.11-1.72; P = 0.003) and stroke (matched HR, 0.65; 95%CI, 0.46-0.92; P = 0.014). Conclusions: In patients with chronic HF, female gender has a significant independent association with improved survival but has no association with all-cause, cardiovascular, or HF hospitalizations.
KW - Gender
KW - Heart failure
KW - Hospitalization
KW - Mortality
KW - Unstable angina pectoris
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U2 - 10.1016/j.ijcard.2009.10.019
DO - 10.1016/j.ijcard.2009.10.019
M3 - Article
C2 - 19939481
AN - SCOPUS:79952815366
SN - 0167-5273
VL - 148
SP - 36
EP - 42
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 1
ER -