Clinical InvestigationCongestive Heart FailureSex differences in in-hospital mortality in acute decompensated heart failure with reduced and preserved ejection fraction
Section snippets
Data source
Data were obtained from the American Heart Association GWTG-HF registry, which has been previously described.9, 10, 11 Hospitals participating in the registry use a Web-based patient management tool (Outcomes Sciences Inc, Cambridge, MA) to collect data for consecutive patients admitted with HF to receive recommendations for qualitative improvement in medical management. Patients hospitalized with new or worsening HF or patients who developed significant HF symptoms such that HF was the primary
Results
The study cohort consisted of 51,428 patients admitted with HF and reduced EF (36% female, 64% male) and 37,699 patients admitted with HF and preserved EF (65% female, 35% male) from 264 GWTG-HF hospitals. Table I shows the baseline characteristics of the cohort according to sex and EF. Patients with HF with reduced EF compared with preserved EF were younger, more likely to be black, less likely to be female; and more likely to have prior HF and higher serum BNP levels on admission. Women
Discussion
In a large, multicenter, national HF registry, we found that despite differences in baseline characteristics, women and men with reduced and preserved EF have similar in-hospital mortality and share many risk factors predicting in-hospital mortality, such as age, systolic blood pressure, heart rate, and history of renal failure/dialysis. Women compared with men with reduced and preserved EF were older and more likely to have hypertension, depression, and valvular heart disease and were less
Conclusions
In a large, multicenter registry, we found that despite substantial differences in baseline characteristics, women and men with reduced and preserved EF have similar in-hospital mortality during an admission for acute decompensated HF. In addition, risk factors including age, systolic blood pressure, heart rate, and history of renal failure/dialysis were highly and similarly predictive of short-term death for men and women with preserved and reduced EF. These findings expand the knowledge base
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Cited by (0)
Funding and relationship with industry: The Get With The Guidelines–Heart Failure (GWTG-HF) program is provided by the American Heart Association. The GWTG-HF program is currently supported, in part, by an unrestricted educational grant from Medtronic, Inc. It has been funded in the past through support from GlaxoSmithKline, Ortho-McNeil, and the American Heart Association Pharmaceutical Roundtable. Eileen Hsich receives funding from American Heart Association Scientist Development Grant 0730307N (E.H.). Adrian Hernandez receives funding from Johnson & Johnson and Amylin and has received honorarium from Amgen and Corthera. Deepak Bhatt receives funding from Amarin, Astra Zeneca, Bristol-Myers Squibb, Eisai, Ethicon, Medtronic, Sanofi Aventis, and The Medicines Company. Gregg Fonarow is a consultant for Novartis.
James L Januzzi, MD served as guest editor for this article.