Female gender and mortality risk in decompensated heart failure

Domenico Scrutinio, Pietro Guida, Andrea Passantino, Rocco Lagioia, Rosa Raimondo, Mario Venezia, Enrico Ammirati, Fabrizio Oliva, Miriam Stucchi, Maria Frigerio

Research output: Contribution to journalArticle

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 1year. 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 1year 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.

Original languageEnglish
Pages (from-to)34-40
Number of pages7
JournalEuropean Journal of Internal Medicine
Volume51
DOIs
Publication statusPublished - May 2018

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