Sex-Specific acute heart failure phenotypes and outcomes from protect

Abstract

Aims Differences in manifestation, treatment, and outcomes of acute heart failure betweenmenandwomenhave not beenwell studied. The objective of this analysis was to characterize differences in clinical presentation, and in-hospital and postdischarge outcomes between sexes in acute heart failure patients. Methods and results Clinical profiles, treatment characteristics, and outcomes were compared between sexes in 2033 patients hospitalized for acute heart failure and impaired renal function.Women comprised 33% of the study population and were older, had higher body mass index, LVEF, and systolic blood pressure, and a greater prevalence of diabetes. At baseline, women showed signs and symptoms of congestion comparable with men, but more often had rales, orthopnoea, and worse renal function.Women were less intensively diuresed, as indicated by lower oral and intravenous diuretic doses used, fewer dose increases, and less total weight loss during hospitalization. Furthermore, hospitalization was slightly but significantly prolonged inwomen(11.04±7. 8 vs. 10.65±8.86 days; P = 0.024). Age-adjusted 180-day mortality was lower in women (15.8% vs. 18.5%, hazard ratio 0.74; 95% confidence interval 0.59-0.93, P = 0.010), but multivariable riskadjusted mortality was similar in both sexes, mainly attributable to lower blood urea nitrogen, higher LVEF, and higher systolic blood pressure in women compared with men. Conclusions Women with acute heart failure present with a clinical profile different from that of men, with more hypertension, diabetes, and depression, and a preserved LVEF. During hospitalization, theywere less intensively diuresed.Nevertheless, risk-adjusted 180-day outcome was similar between sexes. © The Author 2013.