Older females with heart failure undergoing cardiac rehabilitation had a lower risk of death or transfer to acute care compared to males (HR 0.71; 95% CI 0.50-1.00; p=0.049).
Cohort (n=2,345)
Do clinical and functional outcomes differ between older female and male patients with heart failure undergoing inpatient cardiac rehabilitation?
Older women with heart failure undergoing inpatient cardiac rehabilitation demonstrate better survival and are more likely to achieve functional capacity improvements predictive of survival compared to men.
Effect estimate: HR 0.71 (95% CI 0.50-1.00)
p-value: p=0.049
Background: the role that sex plays in impacting cardiac rehabilitation (CR) outcomes remains an important gap in knowledge. Methods: we assessed sex differences in clinical and functional outcomes in 2345 older patients with heart failure (HF) admitted to inpatient CR. Three outcomes were considered: (1) the composite outcome of death during the index admission to CR or transfer to acute care; (2) three-year mortality; (3) change in six-minute walking distance (6MWD) from admission to discharge. Sex differences in outcomes were assessed using multivariable Cox or logistic regression models. Results: the hazard ratios of the composite outcome and of three-year mortality for females vs. males were 0.71 (95%CI:0.50−1.00; p = 0.049) and 0.68 (95%CI:0.59−0.79; p < 0.001), respectively. The standardized mean difference in 6MWD increase from admission to discharge between males and females was 0.10. The odds ratio of achieving an increase in 6MWD at discharge to values higher than the optimal sex-specific thresholds for predicting mortality for females vs. males was 2.21 (95%CI:1.53−3.20; p < 0.001). Conclusion: our findings suggest that older females with HF undergoing CR have better prognosis and garner similar improvement in 6MWD compared with their male counterparts. Nonetheless, females were more likely to achieve levels of functional capacity predictive of improved survival.
Scrutinio et al. (Wed,) conducted a cohort in Heart failure (n=2,345). Female sex vs. Male sex was evaluated on Composite outcome of death during the index admission to CR or transfer to acute care (HR 0.71, 95% CI 0.50-1.00, p=0.049). Older females with heart failure undergoing cardiac rehabilitation had a lower risk of death or transfer to acute care compared to males (HR 0.71; 95% CI 0.50-1.00; p=0.049).