Key result
Women with chronic inflammatory disease and AHF face ~32% higher MACCE and bleeding than men.
Why the study?
Gender disparities in outcomes are well-documented across medical conditions, but gender-specific differences in the prognosis of patients with chronic inflammatory diseases admitted with acute heart failure remained to be evaluated.
Does female gender affect in-hospital mortality and adverse events in patients with chronic inflammatory diseases admitted with acute heart failure?
Observational (n=39,485)
Yes
Does female gender affect in-hospital mortality and adverse events in patients with chronic inflammatory diseases admitted with acute heart failure?
Absolute Event Rate: 2.9% vs 2.6%
p-value: p=0.074
In patients with chronic inflammatory diseases hospitalized for acute heart failure, women experience higher rates of MACCE and major bleeding compared to men, highlighting a need for gender-specific management strategies.
Women with chronic inflammatory disease and acute HF had higher MACCE and bleeding; should not yet change practice and leaves open prospective confirmation.
Background Gender disparities in outcomes across various medical conditions have been well-documented. This study aims to evaluate gender specific differences in the prognosis of patients with chronic inflammatory diseases (CID) admitted with acute heart failure (AHF). Methods The National Inpatient Sample was analyzed to identify all patients admitted to US hospitals with AHF between 2016 and 2019. AHF and CID diagnoses were identified using validated ICD-10 codes. The primary endpoint was in-hospital mortality. Secondary endpoints included major adverse cardiovascular and cerebrovascular events (MACCE), major bleeding events, and mean length of stay (LOS). MACCE was defined as a composite of mortality from any cause, acute ischemic stroke, and cardiac complications. Major bleeding events encompassed gastrointestinal, retroperitoneal, intracranial, or intracerebral hemorrhage, periprocedural or unspecified hemorrhage, and the need for blood transfusion. Results Our analysis includes 1,042,220 AHF admissions, of which 39,485 patients had a diagnosis of CID, with a mean age of 71 years. Of these, 26,770 (68%) were female. The three most common CIDs were Rheumatoid Arthritis (RA), Psoriasis, and SLE. The overall mortality rate across the cohort was 2.8%. In patients with CID, mortality rates were higher in women than men, though not statistically significant (2.9% vs. 2.6%, p=0.074). Women had significantly higher rates of MACCE (6.2% vs. 4.7%, p<0.001) and major bleeding events (1.7% vs. 1.3%, p=0.002). Conversely, mean LOS was significantly longer in men (5.8 vs. 5.5 days, p<0.001). [Figure 1]. Conclusion Our study is the largest to investigate gender disparities among CID patients hospitalized with AHF. In this unique population, mortality rates were similar in both genders, with women suffering from higher rates of MACCE and major bleeding. These findings emphasize the need for further research into gender-specific risk factors and management strategies for this population.
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Roguin et al. (2025) conducted an observational in Acute heart failure with chronic inflammatory disease (n=39,485). Female sex vs. Male sex was evaluated on in-hospital mortality (p=0.074). Among AHF patients with chronic inflammatory disease, women had similar in-hospital mortality to men (2.9% vs 2.6%, p=0.074) but higher rates of MACCE (6.2% vs 4.7%, p<0.001).
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