Cardiac Rehabilitation for Older Women with Heart Failure

Area of Science:

• Cardiology
• Geriatrics
• Rehabilitation Medicine

Background:

• Sex differences in cardiac rehabilitation (CR) outcomes for heart failure (HF) patients are not well understood.
• Investigating these disparities is crucial for optimizing patient care and treatment strategies.

Purpose of the Study:

• To evaluate sex-based differences in clinical and functional outcomes among older patients undergoing inpatient cardiac rehabilitation for heart failure.
• To determine if sex influences mortality, hospital transfer rates, and functional capacity improvements post-CR.

Main Methods:

• Analysis of data from 2345 older patients with HF admitted to inpatient CR.
• Assessment of three primary outcomes: composite of in-hospital death or transfer, three-year mortality, and change in six-minute walking distance (6MWD).
• Utilized multivariable Cox and logistic regression models to assess sex differences.

Main Results:

• Females exhibited significantly lower risks for the composite outcome (HR 0.71) and three-year mortality (HR 0.68) compared to males.
• Both sexes showed similar improvements in 6MWD, with a standardized mean difference of 0.10.
• Females were more likely (OR 2.21) to achieve sex-specific 6MWD thresholds associated with improved survival.

Conclusions:

• Older females with HF in CR demonstrate a better prognosis than their male counterparts.
• While functional capacity gains (6MWD) are comparable, females are more likely to reach higher, survival-predictive functional levels.
• Findings highlight the importance of considering sex in CR strategies for heart failure patients.