Sex differences in outcomes of heart failure in an ambulatory, population-based cohort from 2009 to 2013

Sun, Louise Y.; Tu, Jack V.; Coutinho, Thais; Turek, Michèle; Rubens, Fraser D.; McDonnell, Lisa; Tulloch, Heather; Eddeen, Anan Bader; Mielniczuk, Lisa

doi:10.1503/cmaj.180177

Cited by 35 publications

(41 citation statements)

References 35 publications

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“…Consistent with our higher percentage of women (57%) first admitted because of AHF, similar data have been published in Canada, where an increasing trend of rates of hospital admission were detected in women and declining in men . Furthermore, previous studies have shown that women presented more commonly with “de novo” AHF than men …”

Section: Discussionsupporting

confidence: 91%

“…Similarly, as previously published, the present results were in accordance to other HF studies assessing differences between sex, in which women on their first admission for HF are usually older, with hypertensive rather than ischemic etiology . Unfortunately, as not all of our included patients had systematic echocardiographic study carried out on admission, we could not confirm the reported predominance of preserved HF in women . The higher percentage of dementia in older women with HF has been previously reported as well .…”

Section: Discussionsupporting

confidence: 85%

“…The higher percentage of dementia in older women with HF has been previously reported as well . In contrast, men with a first hospitalization due to HF presented with a higher percentage of chronic obstructive pulmonary disease and chronic kidney disease as comorbidities, as well as stroke and a higher mean CCI score, as it has also been reported . This last finding of increased overall comorbidity in men with HF has also been reported by Conde‐Martel et al …”

Section: Discussionsupporting

confidence: 79%

“…Although several studies have reported lesser or higher rates of unadjusted mortality in women with HF, we have not confirmed any differences in sex prognosis (1‐year global mortality) in the present study population, similarly to the results reported by Galvao et al or by the Canadian study in which sex association disappeared when multivariable adjustment was carried out . In this way, Parissis et al also reported a study in which in‐hospital mortality remained similar between the sexes …”

Section: Discussionsupporting

confidence: 63%

“…Compared with men, women with HF have been reported to often be older, more likely to have preserved ejection fraction, more likely to have a hypertensive etiology and show a different comorbidity profile . Some studies have also reported that HF mortality rates are higher in men than in women .…”

Section: Introductionmentioning

confidence: 99%

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Sex differences in 1‐year mortality risks in older patients experiencing a first acute heart failure hospitalization

Formiga

Moreno-González

Chivite

et al. 2018

Geriatrics Gerontology Int

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Aim To assess whether 1‐year mortality in older patients experiencing a first admission for acute heart failure was related to sex, and to explore differential characteristics according to sex. Methods We reviewed the medical records of 1132 patients aged >70 years of age admitted within a 3‐year period because of a first episode of acute heart failure. We analyzed sex differences. Mortality was assessed using multivariate Cox analysis. Results There were 648 (57.2%) women (mean age 82.1 years) and 484 men (mean age 80.1 years). There were some differences in risk factors: women more often had hypertension, and less frequently had coronary heart disease and comorbidities (women more often had dementia, and men more often had chronic obstructive pulmonary disease, chronic kidney disease and stroke). Women were treated more frequently with spironolactone. The 1‐year all‐cause mortality rate was 30.2% (30.7% women and 29.5% men). Multivariate Cox analysis identified an association between reduced heart failure (hazard ratio [HR] 0.35, 95% confidence interval [95% CI] 0.21–0.59), hemoglobin <10 g/dL (HR 1.99, 95% CI 1.16–3.40), systolic blood pressure (HR 0.98, 95% CI 0.97–0.99), previous diagnosis of dementia (HR 2.07, 95% CI 1.12–3.85), number of chronic therapies (HR 1.12, 95% CI 1.05–1.19) and 1‐year mortality in women. In men, an association with mortality was found for low systolic blood pressure (HR 0.97, 95% CI 0.97–0.98) and higher potassium values (HR 1.42, 95% CI 1.01–2.00). Conclusions Among older patients hospitalized for the first acute heart failure episode, there is a slightly higher predominance of women. There are sex differences in risk factors and comorbidities. Although the mortality rate is similar, the factors associated with it according to sex are different. Geriatr Gerontol Int 2019; 19: 184–188.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Sex differences in 1‐year mortality risks in older patients experiencing a first acute heart failure hospitalization

Formiga

Moreno-González

Chivite

et al. 2018

Geriatrics Gerontology Int

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Association Between Handover of Anesthesiology Care and 1-Year Mortality Among Adults Undergoing Cardiac Surgery

et al. 2022

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IMPORTANCE Handovers of anesthesia care from one anesthesiologist to another is an important intraoperative event. Despite its association with adverse events after noncardiac surgery, its impact in the context of cardiac surgery remains unclear.OBJECTIVE To compare the outcomes of patients who were exposed to anesthesia handover vs those who were unexposed to anesthesia handover during cardiac surgery. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study in Ontario, Canada, included Ontario residents who were 18 years or older and had undergone coronary artery bypass grafting or aortic, mitral, tricuspid valve, or thoracic aorta surgical procedures between 2008 and 2019. Exclusion criteria were non-Ontario residency status and other concomitant procedures.

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National trends in heart failure mortality in men and women, United Kingdom, 2000–2017

Taylor

Ordóñez‐Mena

Jones

et al. 2020

European J of Heart Fail

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Aims To understand gender differences in the prognosis of women and men with heart failure, we compared mortality, cause of death and survival trends over time. Methods and results We analysed UK primary care data for 26 725 women and 29 234 men over age 45 years with a new diagnosis of heart failure between 1 January 2000 and 31 December 2017 using the Clinical Practice Research Datalink, inpatient Hospital Episode Statistics and the Office for National Statistics death registry. Age‐specific overall survival and cause‐specific mortality rates were calculated by gender and year. During the study period 15 084 women and 15 822 men with heart failure died. Women were on average 5 years older at diagnosis (79.6 vs. 74.8 years). Median survival was lower in women compared to men (3.99 vs. 4.47 years), but women had a 14% age‐adjusted lower risk of all‐cause mortality [hazard ratio (HR) 0.86, 95% confidence interval (CI) 0.84–0.88]. Heart failure was equally likely to be cause of death in women and men (HR 1.03, 95% CI 0.96–1.12). There were modest improvements in survival for both genders, but these were greater in men. The reduction in mortality risk in women was greatest for those diagnosed in the community (HR 0.83, 95% CI 0.80–0.85). Conclusions Women are diagnosed with heart failure older than men but have a better age‐adjusted prognosis. Survival gains were less in women over the last two decades. Addressing gender differences in heart failure diagnostic and treatment pathways should be a clinical and research priority.

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Sex differences in outcomes of heart failure in an ambulatory, population-based cohort from 2009 to 2013

Cited by 35 publications

References 35 publications

Sex differences in 1‐year mortality risks in older patients experiencing a first acute heart failure hospitalization

Sex differences in 1‐year mortality risks in older patients experiencing a first acute heart failure hospitalization

Association Between Handover of Anesthesiology Care and 1-Year Mortality Among Adults Undergoing Cardiac Surgery

National trends in heart failure mortality in men and women, United Kingdom, 2000–2017

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