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Sex‐Related Differences in Mortality Following Admission for Acute Heart Failure Across the Left Ventricular Ejection Fraction Spectrum
BACKGROUND: Following a heart failure (HF)‐decompensation, there is scarce data about sex‐related prognostic differences across left ventricular ejection fraction (LVEF) status. We sought to evaluate sex‐related differences in 6‐month mortality risk across LVEF following admission for acute HF. METH...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075214/ https://www.ncbi.nlm.nih.gov/pubmed/34927464 http://dx.doi.org/10.1161/JAHA.121.022404 |
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author | Santas, Enrique Palau, Patricia Llácer, Pau de la Espriella, Rafael Miñana, Gema Núñez‐Marín, Gonzalo Lorenzo, Miguel Heredia, Raquel Sanchis, Juan Chorro, Francisco Javier Bayés‐Genís, Antoni Núñez, Julio |
author_facet | Santas, Enrique Palau, Patricia Llácer, Pau de la Espriella, Rafael Miñana, Gema Núñez‐Marín, Gonzalo Lorenzo, Miguel Heredia, Raquel Sanchis, Juan Chorro, Francisco Javier Bayés‐Genís, Antoni Núñez, Julio |
author_sort | Santas, Enrique |
collection | PubMed |
description | BACKGROUND: Following a heart failure (HF)‐decompensation, there is scarce data about sex‐related prognostic differences across left ventricular ejection fraction (LVEF) status. We sought to evaluate sex‐related differences in 6‐month mortality risk across LVEF following admission for acute HF. METHODS AND RESULTS: We retrospectively evaluated 4812 patients consecutively admitted for acute HF in a multicenter registry from 3 hospitals. Study end points were all‐cause, cardiovascular, and HF‐related mortality at 6‐month follow‐up. Multivariable Cox regression models were fitted to investigate sex‐related differences across LVEF. A total of 2243 (46.6%) patients were women, 2569 (53.4%) were men, and 2608 (54.2%) showed LVEF≥50%. At 6‐month follow‐up, 645 patients died (13.4%), being 544 (11.3%) and 416 (8.6%) cardiovascular and HF‐related deaths, respectively. LVEF was not independently associated with mortality (HR, 1.02; 95% CI 0.99–1.05; P=0.135). After multivariable adjustment, we found no sex‐related differences in all‐cause mortality (P value for interaction=0.168). However, a significant interaction between sex and cardiovascular and HF mortality risks was found across LVEF (P value for interaction=0.030 and 0.007, respectively). Compared with men, women had a significantly lower risk of cardiovascular and HF‐mortality at LVEF<25% and <43%, respectively. On the contrary, women showed a higher risk of HF‐mortality at the upper extreme of LVEF (>80%). CONCLUSIONS: Following an admission for acute HF, no sex‐related differences were found in all‐cause mortality risk. However, when compared with men, women showed a lower risk of cardiovascular and HF‐mortality at the lower extreme of LVEF. On the contrary, they showed a higher risk of HF death at the upper extreme. |
format | Online Article Text |
id | pubmed-9075214 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90752142022-05-10 Sex‐Related Differences in Mortality Following Admission for Acute Heart Failure Across the Left Ventricular Ejection Fraction Spectrum Santas, Enrique Palau, Patricia Llácer, Pau de la Espriella, Rafael Miñana, Gema Núñez‐Marín, Gonzalo Lorenzo, Miguel Heredia, Raquel Sanchis, Juan Chorro, Francisco Javier Bayés‐Genís, Antoni Núñez, Julio J Am Heart Assoc Original Research BACKGROUND: Following a heart failure (HF)‐decompensation, there is scarce data about sex‐related prognostic differences across left ventricular ejection fraction (LVEF) status. We sought to evaluate sex‐related differences in 6‐month mortality risk across LVEF following admission for acute HF. METHODS AND RESULTS: We retrospectively evaluated 4812 patients consecutively admitted for acute HF in a multicenter registry from 3 hospitals. Study end points were all‐cause, cardiovascular, and HF‐related mortality at 6‐month follow‐up. Multivariable Cox regression models were fitted to investigate sex‐related differences across LVEF. A total of 2243 (46.6%) patients were women, 2569 (53.4%) were men, and 2608 (54.2%) showed LVEF≥50%. At 6‐month follow‐up, 645 patients died (13.4%), being 544 (11.3%) and 416 (8.6%) cardiovascular and HF‐related deaths, respectively. LVEF was not independently associated with mortality (HR, 1.02; 95% CI 0.99–1.05; P=0.135). After multivariable adjustment, we found no sex‐related differences in all‐cause mortality (P value for interaction=0.168). However, a significant interaction between sex and cardiovascular and HF mortality risks was found across LVEF (P value for interaction=0.030 and 0.007, respectively). Compared with men, women had a significantly lower risk of cardiovascular and HF‐mortality at LVEF<25% and <43%, respectively. On the contrary, women showed a higher risk of HF‐mortality at the upper extreme of LVEF (>80%). CONCLUSIONS: Following an admission for acute HF, no sex‐related differences were found in all‐cause mortality risk. However, when compared with men, women showed a lower risk of cardiovascular and HF‐mortality at the lower extreme of LVEF. On the contrary, they showed a higher risk of HF death at the upper extreme. John Wiley and Sons Inc. 2021-12-20 /pmc/articles/PMC9075214/ /pubmed/34927464 http://dx.doi.org/10.1161/JAHA.121.022404 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Santas, Enrique Palau, Patricia Llácer, Pau de la Espriella, Rafael Miñana, Gema Núñez‐Marín, Gonzalo Lorenzo, Miguel Heredia, Raquel Sanchis, Juan Chorro, Francisco Javier Bayés‐Genís, Antoni Núñez, Julio Sex‐Related Differences in Mortality Following Admission for Acute Heart Failure Across the Left Ventricular Ejection Fraction Spectrum |
title | Sex‐Related Differences in Mortality Following Admission for Acute Heart Failure Across the Left Ventricular Ejection Fraction Spectrum |
title_full | Sex‐Related Differences in Mortality Following Admission for Acute Heart Failure Across the Left Ventricular Ejection Fraction Spectrum |
title_fullStr | Sex‐Related Differences in Mortality Following Admission for Acute Heart Failure Across the Left Ventricular Ejection Fraction Spectrum |
title_full_unstemmed | Sex‐Related Differences in Mortality Following Admission for Acute Heart Failure Across the Left Ventricular Ejection Fraction Spectrum |
title_short | Sex‐Related Differences in Mortality Following Admission for Acute Heart Failure Across the Left Ventricular Ejection Fraction Spectrum |
title_sort | sex‐related differences in mortality following admission for acute heart failure across the left ventricular ejection fraction spectrum |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075214/ https://www.ncbi.nlm.nih.gov/pubmed/34927464 http://dx.doi.org/10.1161/JAHA.121.022404 |
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