© 2008 European Society of Cardiology
Gender related differences in patients presenting with acute heart failure. Results from EuroHeart Failure Survey II
a Division of Cardiology, Department of Medicine, Helsinki University Central Hospital Finland
b Department of Cardiology, A.Z Middelheim Hospital, University of Antwerp Belgium
c University of Bergen, Cardiology Division, Stavanger University Hospital Norway
d Helmut Drexler, Abt. Kardiologie u. Angiologie, Zentrum Innere Medizin, Med. Hochschule Hannover (MHH) Germany
e Department of Internal Medicine, University Hospital Zurich Switzerland
f Institut für Herzinfarktforschung Ludwigshafen an der Universität Heidelberg Germany
g Cardiology Department, CHU Pitie Salpetriere Paris, France
h Department of Cardiology — Planta 1, Hospital Universitario La Paz Madrid, Spain
i Department of Cardiology, Military Hospital Wroclaw, Poland
j Luigi Tavazzi, Divisione di Cardiologia, Policlinico san Matteo, I.R.C.C.S Pavia, Italy
* Corresponding author. Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Haartmaninkatu 4, POB 340, 00290 Helsinki, Finland. Tel.: +358 9 47172200; fax: +358 9 47174015. E-mail address: markku.nieminen{at}hus.fi (M.S. Nieminen).
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Abstract |
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Aims: This analysis evaluates the gender differences in patients hospitalised for acute heart failure (AHF) in the EuroHeart Failure Survey II (EHFS).
Results: Of the 3580 patients included in EHFS II, 1384 (39%) were women, mean age 73 years. 2196 (61%) were men, mean age 68 years. Women more frequently had new-onset AHF, hypertension and valvular disease and less frequently coronary heart disease or dilated cardiomyopathy compared with men. Smoking, chronic obstructive pulmonary disease, peripheral arterial disease and renal failure were less common, but diabetes and anaemia significantly more frequent in women. Atrial fibrillation and preserved left ventricular function were more common in women. Men were more often non-compliant with medication. After adjustment for indications and age, there were no significant gender differences in prescription of HF medication.
All-cause readmission rate during the one-year follow-up was lower in women. However, the proportion of HF hospitalisation and one-year mortality after discharge (20%) were similar in both genders.
Conclusion: Women frequently present with new-onset AHF. A significant gender difference exists in aetiology, ventricular function and co-morbidities. Women's use of HF medication has improved. These findings emphasize the importance of individualised management and need for more comprehensive recruitment of women in clinical trials.
Key Words: Acute heart failure • Demographics • Echocardiography • Gender • Medication • Prognosis
Received April 19, 2007; Revised November 4, 2007; Accepted December 20, 2008
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