Clinical InvestigationHeart FailureRelationship between sex, ejection fraction, and B-type natriuretic peptide levels in patients hospitalized with heart failure and associations with inhospital outcomes: Findings from the Get With The Guideline–Heart Failure Registry
Section snippets
Data source
We used the American Heart Association GWTG-HF registry, which has been previously described.12., 13., 14. Hospitals participating in the registry collect data for patients admitted with HF as the primary diagnosis to receive recommendations for qualitative improvement in medical management. These hospitals included large tertiary medical centers as well as small community hospitals across the United States. Data collected for each HF patient included demographics, medical/surgical history,
Results
The study cohort of 99,930 HF patients consisted of 47,025 patients admitted with HF and reduced EF (37% female, 63% male), 13,950 HF patients with borderline EF (48% female, 52% male), and 38,955 HF patients admitted with preserved EF (65% female, 35% male) from 277 fully participating hospital GWTG-HF hospitals. The median BNP was 816 pg/mL for the cohort with an IQR of 380 to 1,670 pg/mL. Table I shows the baseline characteristics of the cohort according to sex and EF. Median BNP levels on
Discussion
In a large, multicenter, national HF registry, we found women to have higher median BNP levels than men upon hospital admission for acute decompensated HF with reduced, borderline, and preserved EF. The median BNP levels were highest among HF patients with reduced EF and lowest among those with preserved EF. Admission BNP levels were independently associated with sex and EF. Inhospital mortality was 2.7% and similar among patients with reduced, borderline, and preserved EF. When patients were
Conclusions
In a large, multicenter registry, we found women to have higher median BNP levels than men upon hospital admission for HF with reduced, borderline, and preserved EF. Despite sex/EF differences in baseline BNP values, there were no significant differences in the ability of BNP to predict inhospital mortality among these subgroups. These findings expand the knowledge base regarding sex-based similarities and differences among hospitalized HF patients.
Disclosures
Funding and relationship with industry: The Get With The Guidelines–Heart Failure program is provided by the American Heart Association. The Get With The Guidelines–Heart Failure program has been funded in the past through support from Medtronic, GlaxoSmithKline, Ortho-McNeil, and the American Heart Association Pharmaceutical Roundtable. Adrian Hernandez receives funding from Johnson & Johnson, and Amylin and has received honorarium from Amgen and Corthera. Dr Deepak L. Bhatt discloses the
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Jerome L. Fleg, MD, served as guest editor for this article.