No gender survival difference in a population of patients with chronic heart failure related to left ventricular systolic dysfunction and receiving optimal medical therapy

Arch Cardiovasc Dis. 2008 Apr;101(4):242-8. doi: 10.1016/s1875-2136(08)73699-4.

Abstract

Introduction: Controversial results have been published concerning a possible gender survival difference in patients with chronic heart failure (CHF).

Methods: We analysed data from consecutive patients with stable CHF admitted to our department for prognostic evaluation. Patients underwent coronary angiography, echo-cardiography, radionuclide angiography and a cardiopulmonary exercise test.

Results: We included 613 consecutive patients of whom 115 (19%) were women. The major difference in clinical characteristics was a higher proportion of ischaemic cardiomyopathy in men compared to women (51% vs 28%, p<0.0001) and a lower left ventricular ejection fraction (35+/-9 vs 38+/-9%, p=0.001). Therapeutic management was similar in men and women. A total of 140 cardiovascular-related deaths and 4 urgent transplantations occurred during a median follow-up of 1.234 days. There was no gender difference in cardiac survival. Cardiovascular mortality rates at 2 years were 11% in men and 13% in women.

Conclusions: Despite a lower percentage of ischaemic cardiopathy in women, no gender survival benefit was found in our population of CHF patients receiving optimal medical therapy.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Carbazoles / therapeutic use
  • Cardiomyopathies / drug therapy
  • Cardiomyopathies / mortality
  • Carvedilol
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Heart Failure, Systolic / drug therapy*
  • Heart Failure, Systolic / mortality*
  • Heart Transplantation / statistics & numerical data
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Male
  • Middle Aged
  • Myocardial Ischemia / drug therapy
  • Myocardial Ischemia / mortality
  • Propanolamines / therapeutic use
  • Sex Factors
  • Stroke Volume
  • Vasodilator Agents / therapeutic use

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Carbazoles
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Propanolamines
  • Vasodilator Agents
  • Carvedilol