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Sex differences in patients with advanced heart failure: an analysis of the HELP-HF registry

Mauro Riccardi1,2, Chiara Tedino2, Mauro Chiarito3,4

  • 1Division of Cardiology, Cremona Hospital, Largo Priori Emilio, 1, Cremona 26100, Italy.

ESC Heart Failure
|February 19, 2026
PubMed

Insights

In advanced heart failure (HF), men and women show different clinical profiles but similar 1-year outcomes. This study found no significant sex-based differences in mortality or hospitalizations for advanced HF patients.

Area of Science:

  • Cardiology
  • Clinical Research
  • Sex Differences in Medicine

Background:

  • Sex differences in heart failure (HF) are recognized, yet evidence in advanced HF remains limited.
  • Understanding these differences is crucial for optimizing clinical practice and patient care.

Purpose of the Study:

  • To investigate sex-based differences in clinical characteristics and 1-year outcomes among patients with advanced heart failure.
  • To determine if sex influences the prognosis in patients with high-risk markers for advanced HF.

Main Methods:

  • The HELP-HF registry included 1149 patients with advanced HF markers across four Italian centers.
  • Patient demographics, clinical data, and echocardiographic findings were compared between males and females.
  • The primary endpoint was a composite of all-cause mortality or first HF hospitalization within one year.

Main Results:

  • Males (67.3%) were younger with more cardiovascular diseases and lower ejection fraction; females had more non-cardiac conditions.
  • The 1-year composite endpoint occurred in 43.2% of males and 43.1% of females (P = .857).
  • Multivariable analysis showed no significant impact of sex on the primary endpoint (aHR 1.03; P = .740).

Conclusions:

  • Despite distinct clinical and echocardiographic profiles, sex did not significantly impact 1-year outcomes in this advanced heart failure registry.
  • These findings suggest that sex is not a major determinant of prognosis in patients with advanced HF and high-risk markers.
Abstract

Keywords:
Advanced heart failureDifferencesHELP-HFMortalitySex

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