Sex-related differences in heart failure with preserved ejection fraction

Dewan, P. et al. (2019) Sex-related differences in heart failure with preserved ejection fraction. Circulation: Heart Failure, 12(12), e006539. (doi: 10.1161/CIRCHEARTFAILURE.119.006539) (PMID:31813280)

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Abstract

To describe characteristics and outcomes in women and men with heart failure with preserved ejection fraction. Baseline characteristics (including biomarkers and quality of life) and outcomes (primary outcome: composite of first heart failure hospitalization or cardiovascular death) were compared in 4458 women and 4010 men enrolled in CHARM-Preserved (Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity) (EF≥45%), I-Preserve (Irbesartan in heart failure with Preserved ejection fraction), and TOPCAT-Americas (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial). Women were older and more often obese and hypertensive but less likely to have coronary artery disease or atrial fibrillation. Women had more symptoms and signs of congestion and worse quality of life. Despite this, the risk of the primary outcome was lower in women (hazard ratio, 0.80 [95% CI, 0.73-0.88]), as was the risk of cardiovascular death (hazard ratio, 0.70 [95% CI, 0.62-0.80]), but there was no difference in the rate for first hospitalization for heart failure (hazard ratio, 0.92 [95% CI, 0.82-1.02]). The lower risk of cardiovascular death in women, compared with men, was in part explained by a substantially lower risk of sudden death (hazard ratio, 0.53 [0.43-0.65]; <0.001). E/A ratio was lower in women (1.1 versus 1.2). There are significant differences between women and men with heart failure with preserved ejection fraction. Despite worse symptoms, more congestion, and lower quality of life, women had similar rates of hospitalization and better survival than men. Their risk of sudden death was half that of men. URL: https://www.clinicaltrials.gov. Unique identifier: NCT00853658, NCT01035255.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Jhund, Dr Pardeep and Campbell, Dr Ross and Dewan, Dr Pooja and McMurray, Professor John and Petrie, Professor Mark
Authors: Dewan, P., Rorth, R., Raparelli, V., Campbell, R. T., Shen, L., Jhund, P. S., Petrie, M. C., Anand, I. S., Carson, P. E., Desai, A. S., Granger, C. B., Køber, L., Komajda, M., McKelvie, R. S., O'Meara, E., Pfeffer, M. A., Pitt, B., Solomon, S. D., Swedberg, K., Zile, M. R., and McMurray, J. J.V.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Circulation: Heart Failure
Publisher:Lippincott Williams and Wilkins
ISSN:1941-3289
ISSN (Online):1941-3297
Copyright Holders:Copyright © 2019 American Heart Association, Inc.
First Published:First published in Circulation: Heart Failure 12(12):e006539
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
303944BHF Centre of ExcellenceRhian TouyzBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science