Female patients with heart failure had significantly lower 3-year all-cause mortality compared with male patients (37.0% vs. 43.9%; HR 0.64; 95% CI 0.45-0.92; P=0.016).
Cohort (n=567)
Does female sex affect clinical characteristics, biomarker levels, and mortality in patients with heart failure compared to male sex?
Female heart failure patients have a distinct clinical presentation, lower levels of inflammatory and remodeling biomarkers, and better survival compared to male patients.
Effect estimate: HR 0.64 (95% CI 0.45-0.92)
Absolute Event Rate: 37% vs 43.9%
p-value: p=0.016
AIMS: Despite disparities in pathophysiology and disease manifestation between male and female patients with heart failure, studies focusing on sex differences in biomarkers are scarce. The purpose of this study was to assess sex-specific variation in clinical characteristics and biomarker levels to gain more understanding of the potential pathophysiological mechanisms underlying sex differences in heart failure. METHODS AND RESULTS: Baseline demographic and clinical characteristics, multiple biomarkers, and outcomes were compared between men and women in 567 patients. The mean age of the study group was 71 ± 11 years and 38% were female. Women were older, had a higher body mass index and left ventricular ejection fraction, more hypertension, and received more diuretic and antidepressant therapy, but less ACE-inhibitor therapy compared with men. After 3 years, all-cause mortality was lower in women than men (37.0 vs. 43.9%, multivariable hazard ratio = 0.64; 95% confidence interval 0.45-0.92, P = 0.016). Levels of biomarkers related to inflammation C-reactive protein, pentraxin 3, growth differentiation factor 15 (GDF-15), and interleukin 6 and extracellular matrix remodelling (syndecan-1 and periostin) were significantly lower in women compared with men. N-terminal pro-brain natriuretic peptide, TNF-αR1a, and GDF-15 showed the strongest interaction between sex and mortality. CONCLUSION: Female heart failure patients have a distinct clinical presentation and better outcomes compared with male patients. The lower mortality was independent of differences in clinical characteristics, but differential sex associations between several biomarkers and mortality might partly explain the survival difference.
Meyer et al. (Fri,) conducted a cohort in Heart failure (n=567). Female sex vs. Male sex was evaluated on All-cause mortality (HR 0.64, 95% CI 0.45-0.92, p=0.016). Female patients with heart failure had significantly lower 3-year all-cause mortality compared with male patients (37.0% vs. 43.9%; HR 0.64; 95% CI 0.45-0.92; P=0.016).