Author/Editor		Ahmed, Mustafa I; Lainščak, Mitja; Mujib, Marjan; Love, Thomas E; Aban, Inmaculada; Pina, Ileana L; Aronow, Wilbert S; Bittner, Vera; Ahmed, Ali
Title		Gender-related dissociation in outcomes in chronic heart failure: reduced mortality but similar hospitalization in women
Type		članek
Source		Int J Cardiol
Publication year		2009
Language		eng
Abstract		Background: The impact of gender on major natural history end points in heart failure (HF) has not been examined in a propensity-matched study.Methods: Of the 7788 chronic systolic and diastolic HF patients in the Digitalis Investigation Group trial1926 were women. Propensity scores for female gender were used to assemble a cohort of 1669 pairs of men and women who were well-balanced on 32 measured baseline characteristics. Matched hazard ratios (HR) and 95% confidence intervals (CI) for outcomes associated with female gender were calculated using stratified Cox regression modeis.Results: All-cause mortality occurred in 36% (rate. 1256/10,000 person-years) and 30% (rate. 1008/ 10,000 person-years) of matched men and women respectively during 5 years of follow up (HR when women were compared with men, 0.82. 95% CI. 0.72-0.94. P= 0.004). Female gender was al so associated with reduced cardiovascular mortality (matched HR, 0.85; 95% CI, 0.73-0.99, P= 0.037) and a trend toward reduced non-cardiovascular mortality (matched HR, 0.73; 95% CI. 0.53-1.00; P= 0.053). AlI-cause hospitalization occurred in 67% (rate, 4003/10,000 person-years) and 65% (rate, 3762/10,000 person-years) matched male and female patients respectively (HR for women. 1.03.95% CI, 0.93-1.15, P=0.538). Female gender was not associated with cardiovascular or HF hospitalization but was associated with hospitalization due to unstable angina pectoris (matched HR. 1.38; 95%CI. 1.11-1.72; P=0.003) and stroke (matched HR. 0.65; 95%CI, 0.46-0.92; P=0.014).Conclusions: In patients with chronic HF, female gender has a significant independent association with improved survival but has no association with all-ca use. cardiovascular. or HF hospitalizations.
Descriptors		HEART FAILURE, CONGESTIVE ANGINA, UNSTABLE HOSPITALIZATION SEX FACTORS SURVIVAL ANALYSIS REGRESSION ANALYSIS