Sex-Specific Predictors of Long-Term Mortality in Elderly Patients with Ischemic Cardiomyopathy

Area of Science:

• Cardiology
• Geriatrics
• Clinical Research

Background:

• Ischemic heart failure (HF) is a leading cause of global morbidity and mortality.
• Sex-specific mortality predictors in elderly patients with ischemic cardiomyopathy (ICMP) remain understudied.
• Understanding these differences is crucial for targeted interventions and improved patient outcomes.

Purpose of the Study:

• To investigate and compare sex-specific predictors of long-term mortality in elderly patients diagnosed with ICMP.
• To identify factors that independently influence survival rates in male versus female patients with ICMP.
• To inform sex-specific treatment strategies for improving long-term survival in this vulnerable population.

Main Methods:

• A cohort of 536 elderly patients (over 65 years) with ICMP was followed for a mean of 5.4 years.
• Mortality events were recorded, and univariate and multivariate analyses were performed to identify predictors.
• Statistical comparisons were made between male and female patient subgroups to determine sex-specific associations.

Main Results:

• Low ejection fraction was an independent predictor of mortality in both sexes.
• In females, diabetes, elevated e/e', elevated pulmonary artery systolic pressure, anemia, and non-use of beta-blockers or angiotensin receptor blockers predicted mortality.
• In males, hypertension, elevated creatinine, and non-use of statins were independent predictors of mortality.

Conclusions:

• Mortality predictors in elderly ICMP patients exhibit significant sex differences.
• Systolic dysfunction affects both sexes, while diastolic dysfunction, specific medications (beta-blockers, ARBs in females; statins in males) play crucial sex-specific roles.
• Implementing sex-specific management strategies is essential for enhancing long-term survival in elderly patients with ICMP.