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

Abstract

Objectives: 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.

Method: 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.

Results: 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).

Conclusion: 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.