Influence of gender on the clinical characteristics and prognosis of patients hospitalized for heart failure

Background and objectives. The natural history of heart failure (HF) may be different in women due to their clinical characteristics, treatment and prognosis being distinct. Our aim was to describe the differential characteristics of women hospitalized with HF. Methods. We prospectively studied consecutive patients who were discharged with a diagnosis of HF (n=412). Clinical, laboratory, echocardiographic, and therapeutic variables were recorded at discharge. During follow-up (16 [9] months), all-cause mortality and the need for rehospitalization were recorded. Results. Compared with men, women (n=157, 38%) were older (75 [12] years vs 71 [18] years, P<.001), had a higher prevalence of arterial hypertension (71% vs 51%, P<.001), had more frequently been previously hospitalized for HF (36% vs 25%, P=.02), had a higher prevalence of HF with a preserved left ventricular ejection fraction (LVEF) (44% vs 21%, P<001), had less coronary disease (34% vs 49%, P=.007), had more hypertensive cardiomyopathy (17% vs 8%, P=.006), had worse renal function (52 [25] vs 58 [25] mL/min per 1.73m 2 , P=.002), and had lower hemoglobin levels (12.1 [1.7] vs 12.9 [1.9] g/dL, P<.001). This clinical profile resulted in less use of coronary angiography (22% vs 37%, P=.001), antiplatelet drugs (45% vs 62%, P=.001), and beta-blockers (39% vs 50%, P=.03). In addition, women received statin treatment less often (31% vs 45%, P=.003). Nevertheless, mortality (23% vs 18%, P=.26) and the rehospitalization rate (44% vs 46%, P=.81) were similar. In women, age (hazard ratio [HR]= 1.05; 95% confidence interval [CI] 1.01‐1.09; P=.036) and anemia (HR=2.43; 95% CI, 1.16‐5.12; P=.015) were independent predictors of death. Conclusions. Women hospitalized for HF had a distinct clinical profile: their LVEF was greater and they more frequently had comorbid conditions. This led to different treatment, though prognosis was similar to that in men.