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Sex Differences in Prognosis of Heart Failure Due to Ischemic and Nonischemic Cardiomyopathy

Antonio de Padua Mansur1, Antonio Carlos Pereira-Barretto1, Carlos Henrique Del Carlo2

  • 1Serviço de Prevencao, Cardiopatia na Mulher e Reabilitação Cardiovascular, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil.

Journal of Clinical Medicine
|August 26, 2023
PubMed

Insights

Women with ischemic cardiomyopathy (iCMP) have a better prognosis than men. However, sex was not an independent predictor of death for either ischemic or non-ischemic cardiomyopathy (niCMP).

Area of Science:

  • Cardiology
  • Clinical Research
  • Sex Differences in Medicine

Background:

  • Limited research exists on sex-specific predictors of death in heart failure (HF) patients with ischemic (iCMP) and non-ischemic cardiomyopathy (niCMP).
  • Understanding these differences is crucial for personalized treatment strategies.

Purpose of the Study:

  • To assess sex differences in the prognosis and predictors of death for patients with niCMP and iCMP.
  • To identify key factors influencing mortality in male and female HF patients.

Main Methods:

  • A cohort of 7487 HF patients was analyzed between February 2017 and September 2020.
  • Kaplan-Meier, Cox proportional hazard models, and chi-square tests were employed to determine death predictors.
  • Clinical and echocardiographic data were collected for comprehensive analysis.

Main Results:

  • Women with iCMP and niCMP were older and had higher ejection fraction and smaller LV diastolic diameter than men.
  • Over 2.26 years, death rates were 14.7% in women and 15.7% in men with niCMP, and 24.5% in women and 29.8% in men with iCMP.
  • Men with iCMP had a higher cumulative incidence of death (log-rank p < 0.0001), while rates were similar for niCMP.

Conclusions:

  • Women with iCMP demonstrated a better prognosis compared to men, whereas prognoses were similar for niCMP.
  • Sex was not identified as an independent predictor of mortality in either iCMP or niCMP.
  • Chronic kidney disease, diabetes, stroke, atrial fibrillation, age, and myocardial infarction were key predictors of death in iCMP.
Abstract

Keywords:
cardiomyopathyheart failureischemic heart diseasemenprognosiswomen

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