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Sex Differences in Sudden Cardiac Death During Long-Term Follow-up in Patients With Chronic Heart Failure　- A Report

Hideka Hayashi1, Kotaro Nochioka1, Makoto Nakano1

  • 1Department of Cardiovascular Medicine, Tohoku University Hospital.

Circulation Journal : Official Journal of the Japanese Circulation Society
|January 19, 2025
PubMed

Insights

Sudden cardiac death (SCD) occurs less in women with chronic heart failure (HF) after five years. Left ventricular enlargement is a key long-term risk factor for both sexes in HF management.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Sudden Cardiac Death Studies

Background:

  • Sudden cardiac death (SCD) incidence is generally higher in men than women.
  • Limited data exist on sex-specific SCD differences in chronic heart failure (HF) patients with varying left ventricular ejection fraction (LVEF).

Purpose of the Study:

  • To investigate sex differences in SCD incidence, timing, and risk factors among chronic HF patients.
  • To analyze long-term prognostic factors for SCD in a diverse HF population.

Main Methods:

  • Analysis of 4,683 patients (3,186 men, 1,497 women) from the CHART-2 prospective observational cohort.
  • Median follow-up of 8.8 years to assess SCD events and identify risk factors.

Main Results:

  • A total of 215 SCDs occurred (160 men, 55 women).
  • SCD incidence rates were 6.1/1000 person-years in men and 4.6/1000 person-years in women (P=0.088).
  • Beyond 5 years, women had significantly lower SCD rates (3.6 vs. 5.9/1000 person-years; P=0.044). Age, elevated B-type natriuretic peptide, LVEF <50%, and left ventricular enlargement were key prognostic factors.

Conclusions:

  • Significant sex differences in SCD exist, particularly after 5 years, with lower prevalence in women.
  • Left ventricular enlargement is a critical long-term predictor of SCD in both sexes.
  • Preventing left ventricular remodeling is crucial for managing HF and reducing SCD risk.
Abstract

Keywords:
Heart failureLeft ventricular enlargementSex differenceSudden cardiac death

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