Sex differences in mortality and hospitalisation in heart failure patients: sex differences in heart failure

We aimed to investigate the clinical and demographic characteristics, and mortality differences between male and female patients with heart failure (HF) with reduced ejection fraction (HFrEF) admitted to our hospital.

The files of patients who were referred to the HF outpatient clinic of our hospital in Antalya and the surrounding provinces between 2014 and 2019 were analysed retrospectively.

875 patients were included in the study (63.75 ± 13.26 years; 73.1% male). The women were older than the men (67 vs. 64 years, p = 0.002), with higher body mass indexes (27.05 vs. 26.44 kg/m², p = 0.029) and higher heart rates (78 bpm vs. 76 bpm, p = 0.034). The majority of women had non-ischemic HFrEF (55.7 vs. 38.1% p < 0.001) in contrast to the men, and the prevalence of hypertension and diabetes mellitus was more frequent than in men (65.5%, 52.3% vs. 48.6%, 35.2%, p < 0.001, respectively). Atrial fibrillation was also observed more frequently in women (25.5 vs 17.2%, p = 0.032). Female patients had higher N-terminal pro-B-type natriuretic peptide (2543 vs. 1564 pg/mL, p < 0.001) and lower estimated glomerular filtration rate (59.4 vs. 66.8%, p < 0.001). The all-cause 1-year mortality rate was 12.3% among female patients and 9.1% among male patients. There was no difference between the sexes in total cumulative survival (p = 0.118).

There are significant sex differences in patients with HFrEF in terms of clinical features, laboratory parameters, aetiologic causes, and survival. We hope that this study will create a significant awareness in the treatment and follow-up of patients with HFrEF in our country.