Key result
Male sex was not associated with a significant difference in mortality compared to female sex among patients with acute heart failure (HR 0.9932), despite differences in baseline comorbidities.
Why the study?
Real-world investigations focused on gender-associated characteristics and outcomes of acute heart failure were lacking in India.
Do gender differences impact clinical characteristics and mortality outcomes in patients with acute heart failure in India?
Observational (n=5,182)
Yes
Do gender differences impact clinical characteristics and mortality outcomes in patients with acute heart failure in India?
Hazard Ratio: 0.9932 (95% CI 0.8619–1.144)
Absolute Event Rate: 17.8% vs 18.6%
In an Indian registry of acute heart failure, women presented more often with HFpEF and hypertension, while men had more ischemic heart disease, but mortality outcomes up to one year were similar between genders.
Similar mortality by gender supports uniform risk assessment in Indian acute HF; extends registry data but leaves open gender-specific intervention trials.
Background Real-world investigations focused on gender-associated characteristics of Acute Heart failure (AHF) are lacking. The current study, from a national heart failure registry, aims to investigate gender-based patterns and outcomes among AHF patients in India. Methods This prospective Indian College of Cardiology National Heart Failure Registry enrolled patients admitted with AHF in 17 centres from 2019-2021. Demographics, aetiology, co-morbidities, laboratory investigations, electrocardiogram, and echo parameters were captured. In-hospital 30-day and one-year mortality rates were recorded. The prescription and adherence to the three Guideline Directed Medical Therapy (GDMT) prescription in 2019-2021 were also captured at discharge. Mortality rate Gender-based comparisons were tested at a 5% level of significance. Results The study enrolled 5182 AHF patients, 66.7% male (M) and 33.3% female (F). The mean age of the male (M) population was 60.9±13.3, and the female (F) population was 62.8±14 years. Women had a higher prevalence of heart failure with preserved ejection fraction (HFpEF)(F:12.9%, M:7.3%; P <0.0001), hypertension (F: 57.2%, M: 52.4%; P =0.0011) and arrhythmia (F:15.2%, M:11.7%; P =0.0005). Men had a higher incidence of ischemic heart disease (M:76.2%, F:67.5%; P <0.001). Adherence to Renin-angiotensin-aldosterone system (RAAS) inhibitors, Beta-blockers and Mineralocorticoid receptor antagonists (MRAs) was low (18.8% (M); 15.9% (F)). The mortality rate, in-hospital mortality was 6.9% (M:6.5%, F:7.7%), up to one-month was 11.8% (M:11.6%, F:12.3%) or one-year was 18.1% (M:17.8%, F:18.6%). Conclusion Women represent one-third of the population with AHF. Hypertension and HFpEF were more common in women, while ischemic heart disease was more prevalent in men. No gender-based differences were observed in the mortality outcomes. Both groups had low GDMT adherence. This calls for effective strategies to improve HF care in the country.
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Jayagopal et al. (2025) conducted an observational in Acute Heart Failure (n=5,182). Male sex vs. Female sex was evaluated on One-year mortality (HR 0.9932, 95% CI 0.8619-1.144). Male sex was not associated with a significant difference in mortality compared to female sex among patients with acute heart failure (HR 0.9932), despite differences in baseline comorbidities.
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