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Published on: June 10, 2025
Gender differences in patients admitted with advanced decompensated heart failure
Wilfried Mullens1, Zuheir Abrahams, George Sokos
1Department of Cardiovascular Medicine, Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, Ohio, USA.
The American Journal of Cardiology
|August 6, 2008
Summary
Women with advanced decompensated heart failure (ADHF) show similar outcomes to men. However, women with nonischemic cardiomyopathy have better survival, while those with ischemic cardiomyopathy face higher mortality.
Area of Science:
- Cardiology
- Clinical Medicine
- Sex Differences in Health
Background:
- Previous studies suggest female gender is linked to better survival in stable heart failure.
- Advanced decompensated heart failure (ADHF) presents unique challenges and potential gender-specific variations.
- Understanding these differences is crucial for optimizing treatment strategies.
Purpose of the Study:
- To investigate gender-specific differences in clinical presentation of ADHF.
- To assess gender-specific responses to intensive medical therapy in ADHF.
- To compare outcomes, including mortality and rehospitalization, between men and women with ADHF.
Main Methods:
- Retrospective review of 278 patients with ADHF treated in a dedicated heart failure intensive care unit.
- Analysis of baseline characteristics, medical therapy, hemodynamic data, and outcomes.
- Subgroup analysis based on etiology of heart failure (ischemic vs. nonischemic cardiomyopathy).
Main Results:
- Women had similar baseline characteristics and received comparable medical therapy to men, except for a higher prevalence of nonischemic cause.
- Intensive medical therapy improved hemodynamics similarly in both genders.
- Overall all-cause mortality and heart failure rehospitalization rates were similar between men and women.
Conclusions:
- Women with ADHF exhibit similar presentation and response to intensive medical therapy as men.
- While overall outcomes are comparable, women with nonischemic cardiomyopathy show improved survival.
- Women with ischemic cardiomyopathy experienced higher all-cause mortality compared to men.
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