Clinical characteristics and in-hospital outcome of heart failure in women: a single center registry from Egyptian cardiac care unit

Abstract

BackgroundThis study represents figures from a cardiac care unit (CCU) of a university hospital; it describes an example of a tertiary academic center in Egypt and provides an epidemiological view of the female HF patients, their risk profile, and short-term outcome during hospitalization.ResultsIt is a local single-center cross-sectional observational registry of CCU patients 1 year from July 2015 to July 2016. Patient’s data were collected through a special software program. Women with evidence of HF were thoroughly studied.Among the 1006 patients admitted to CCU in 1 year, 345 (34.2%) patients were females and 118 (34.2%) had evidence of HF, whereas 661 (65.7%) were males and 178 (26.9%) of them had HF. Women with HF showed 11.7% prevalence of the total population admitted to CCU. 72.7% were HFrEF and 27.3% were HFpEF. Compared to men, women with HF were older in age, more obese, less symptomatic than men, had higher incidence of associated co-morbidities, less likely to be re-admitted for HF, and less likely to have ACS and PCI. Valvular heart diseases and cardiomyopathies were the commonest etiologies of their HF. Women had more frequent normal ECG, higher EF%, and smaller LA size. There is no difference in medications and CCU procedures. While females had shorter stay, there is no significant difference in hospital mortality compared to male patients.ConclusionsDespite higher prevalence of HF in females admitted to CCU and different clinical characteristics and etiology of HF, female gender was associated with similar prognosis during hospital course compared to male gender.

Heart Failure with Reduced Ejection Fraction—Does Sex Matter?

“…They are less likely to have atrial fibrillation (AF) and ischaemic heart disease as underlying contributors compared to male HFrEF patients [2,6]. In keeping with this, they are less likely to have had myocardial infarction, percutaneous coronary intervention and coronary artery bypass grafting [4]. Diabetes is an important risk factor in HF for both sexes, but to a greater degree in women [8].…”

“…Whilst in both sexes the incidence of HF increases with age, it is well established that women are more likely to be older when presenting with HFrEF [3]. This is also reflected in more recent research over the last 5 years [4][5][6].…”

“…In terms of presenting features of HFrEF, most recent data concurred with older data [7,21] showing that women are more likely to experience symptoms like dyspnoea, exhibit a third heart sound (S3 gallop), increased jugular venous pressure, and leg oedema when compared to men. One paper conflicted with this but had a smaller sample size of 118 women and was restricted to a CCU setting [4]. It was reported that women experienced less symptoms with more normal ECGs.…”

“…Echocardiography analysis highlights that women have higher ejection fractions with smaller left atria, higher longitudinal strain and higher circumferential strain [4,22]. Asian women in particular more commonly have concentric left ventricular geometry compared to male counterparts [7].…”

Heart Failure 2019. Insights From the National Society of Cardiology Journals

“…Данные недостатки зависят от социально-экономических факторов и в подавляющем большинстве случаев оказывают негативное влияние в странах со средним уровнем дохода, нежели с высоким. В одноцентровом наблюдательном исследовании 1006 пациентов, поступивших в сосудистое отделение в Египте, Badran HM, et al [1]…”