Gender Differences in Presentation, Treatment, and In-Hospital Outcome of Patients Admitted With Heart Failure...

Area of Science:

• Cardiology
• Clinical Medicine
• Gender Studies in Health

Background:

• Heart failure (HF) frequently coexists with atrial fibrillation (AF), affecting nearly 25% of HF patients.
• This significant overlap highlights a need for further research into the specific characteristics and outcomes of patients with both conditions.
• Existing research has under-addressed the subgroup of patients experiencing both HF and AF.

Purpose of the Study:

• To investigate potential gender-based disparities in the clinical presentation of patients with HF and AF.
• To analyze differences in treatment approaches and in-hospital outcomes between men and women diagnosed with HF and AF.
• To identify factors influencing in-hospital mortality in this patient population based on gender.

Main Methods:

• Utilized data from the Get With the Guidelines-Heart Failure (GWTG-HF) registry, encompassing 6,496 HF patients from 2005-2012.
• Included 1,561 patients (24%) with concomitant AF, comparing characteristics and outcomes between genders.
• Employed Pearson chi-square and Student T-tests for comparative analysis and multivariate logistic regression to predict in-hospital mortality.

Main Results:

• Women with HF and AF were older, had higher ejection fractions, systolic hypertension, and more health insurance than men.
• Despite higher CHADS2 scores in women, anticoagulation prescription rates before admission were similar.
• In-hospital mortality rates were comparable between genders, though predictors differed: decreased appetite/early satiety for women, and age, chest pain, and decreased appetite/early satiety for men.

Conclusions:

• Women with HF and AF exhibit distinct clinical presentations and comorbidities compared to men.
• Despite these demographic and clinical variations, both genders experienced similar in-hospital mortality rates.
• Identifying gender-specific predictors of mortality, such as decreased appetite, is essential for refining management strategies in HF patients with AF.