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Gender difference in the impact of Ischaemic heart disease on heart failure
Hyun-Jin Kim1, Myung-A Kim2, Hack-Lyoung Kim2
1Cardiovascular center, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
Insights
Ischaemic heart disease (IHD) significantly increases mortality risk in women with heart failure with reduced ejection fraction (HFrEF). This risk was not observed in men, highlighting a critical gender-specific difference in HFrEF outcomes.
Area of Science:
- Cardiology
- Clinical Outcomes Research
- Gender-Specific Medicine
Background:
- Ischaemic heart disease (IHD) impact on heart failure (HF) is evolving.
- Uncertainty exists regarding IHD's role in clinical outcomes by gender.
- This study focuses on gender differences in IHD's impact on long-term outcomes in heart failure with reduced ejection fraction (HFrEF).
Purpose of the Study:
- To evaluate gender differences in the impact of IHD on long-term clinical outcomes.
- To assess the independent risk of IHD for mortality in HFrEF patients stratified by gender.
Main Methods:
- Prospective, multicentre cohort study using a nationwide registry.
- Included 1638 patients with HFrEF, classified by gender.
- Primary outcome was all-cause death during follow-up; Cox regression analysis performed.
Main Results:
- Women with HFrEF and IHD had significantly lower survival rates (74.8% vs 84.9%, P=.001).
- No significant survival difference was observed in men with HFrEF with or without IHD.
- IHD independently increased all-cause mortality risk by 1.43-fold in women (OR 1.43, P=.020).
Conclusions:
- Ischaemic heart disease is an independent risk factor for long-term mortality in women with HFrEF.
- Active evaluation of IHD in women with HF is crucial for outcome prediction and treatment initiation.
- Women with HF due to IHD require meticulous management to prevent poor prognosis.
Background:
Although the impact of ischaemic heart disease (IHD) on heart failure (HF) is evolving, there is uncertainty about the role of IHD in determining the risk of clinical outcomes by gender. This study evaluated the gender difference in the impact of IHD on long-term clinical outcomes in patients with heart failure reduced ejection fraction (HFrEF).
Methods:
Study data were obtained from a nationwide registry, which is a prospective multicentre cohort that included 3200 patients who were hospitalized for HF. A total of 1638 patients with HFrEF were classified by gender. The primary outcome was all-cause death during follow-up.
Results:
In total, 133 women (18.9%) died and 168 men (18.0%) died during the follow-up (median, 489 days). Women with HFrEF with IHD had a significantly lower cumulative survival rate than women without IHD at the long-term follow-up (74.8% vs 84.9%, log-rank P = .001). However, the survival rate was not different in men with HFrEF with IHD compared with men without IHD. A Cox regression analysis showed that IHD had a 1.43-fold increased risk for all-cause mortality independently in women after adjusting for confounding factors (odds ratio 1.43, 95% confidence interval 1.058-1.929, P = .020).
Conclusion:
Ischaemic heart disease was an independent risk factor for long-term mortality in women with HFrEF. IHD should be actively evaluated in women with HF for predicting clinical outcomes and initiating appropriate treatment. Women with HF caused by IHD should be treated more meticulously to avoid a poor prognosis.
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