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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Heart-Assist Devices
Heart Failure
Heart Transplantation
Mortality
Confidence Intervals
Propensity Score
Survival
Incidence
Uncertainty
Hospitalization
Odds Ratio

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Female gender and mortality risk in decompensated heart failure. / Scrutinio, Domenico; Guida, Pietro; Passantino, Andrea; Lagioia, Rocco; Raimondo, Rosa; Venezia, Mario; Ammirati, Enrico; Oliva, Fabrizio; Stucchi, Miriam; Frigerio, Maria.

In: European Journal of Internal Medicine, Vol. 51, 05.2018, p. 34-40.

Research output: Contribution to journalArticle

Scrutinio, Domenico ; Guida, Pietro ; Passantino, Andrea ; Lagioia, Rocco ; Raimondo, Rosa ; Venezia, Mario ; Ammirati, Enrico ; Oliva, Fabrizio ; Stucchi, Miriam ; Frigerio, Maria. / Female gender and mortality risk in decompensated heart failure. In: European Journal of Internal Medicine. 2018 ; Vol. 51. pp. 34-40.
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title = "Female gender and mortality risk in decompensated heart failure",
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.",
author = "Domenico Scrutinio and Pietro Guida and Andrea Passantino and Rocco Lagioia and Rosa Raimondo and Mario Venezia and Enrico Ammirati and Fabrizio Oliva and Miriam Stucchi and Maria Frigerio",
note = "Copyright {\circledC} 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.",
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T1 - Female gender and mortality risk in decompensated heart failure

AU - Scrutinio, Domenico

AU - Guida, Pietro

AU - Passantino, Andrea

AU - Lagioia, Rocco

AU - Raimondo, Rosa

AU - Venezia, Mario

AU - Ammirati, Enrico

AU - Oliva, Fabrizio

AU - Stucchi, Miriam

AU - Frigerio, Maria

N1 - Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

PY - 2018/5

Y1 - 2018/5

N2 - 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.

AB - 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.

U2 - 10.1016/j.ejim.2018.01.011

DO - 10.1016/j.ejim.2018.01.011

M3 - Article

VL - 51

SP - 34

EP - 40

JO - European Journal of Internal Medicine

JF - European Journal of Internal Medicine

SN - 0953-6205

ER -