[Influence of sex on mortality in hospitalized patients with congestive heart failure and preserved or depressed systolic function]. / Influencia del sexo en la mortalidad a largo plazo de pacientes hospitalizados por insuficiencia cardíaca con función sistólica conservada o deprimida.

INTRODUCTION AND OBJECTIVES: There is some controversy about the impact of sex on mortality in patients with heart failure. Moreover, little is known about its influence on prognosis in patients with preserved systolic function. The objective of this study was to investigate the influence of sex on survival in patients with heart failure, including subgroups with preserved or depressed left ventricular ejection fraction (LVEF). PATIENTS AND METHOD: The study included 1252 patients (767 male, 61.3%) who were admitted with heart failure to the cardiology department of a tertiary hospital. The median follow-up period was 2.3 years, with the mortality rate rising to 41% after 12 years of follow-up. A LVEF less than 50% was observed in 60.2% of patients. Female patients were older (73.4 +/- 10.0 years vs 66.8 +/- 11.9 years; P < .001), a higher proportion had preserved systolic function (52.2% vs 31.9%; P < .001), and fewer had ischemic cardiopathy (44.1% vs 53.2%; P < .001). RESULTS: In the group as a whole, the influence of sex on prognosis did not reach statistical significance: the hazard ratio in males compared with females was 1.253 (95%CI, 0.978-1.605; P = .074). In addition, no influence of sex on survival was observed in subgroups with preserved or depressed systolic function. CONCLUSIONS: In a large cohort, we did not observe any influence of sex on mortality in hospitalized patients with heart failure, either in the group as a whole or in subgroups with preserved or depressed left ventricular systolic function, despite a tendency towards higher mortality in males.

Influencia del sexo en la mortalidad a largo plazo de pacientes hospitalizados por insuficiencia cardíaca con función sistólica conservada o deprimida / Influence of sex on mortality in hospitalized patients with congestive heart failure and preserved or depressed systolic function

Introducción y objetivos. Hay una relativa controversia sobre el impacto del sexo en la mortalidad de los pacientes con insuficiencia cardíaca y es escasa la información acerca de su influencia en el grupo de pacientes con función sistólica ventricular izquierda conservada. El objetivo es estudiar la influencia del sexo en el pronóstico de la insuficiencia cardíaca, así como en los subgrupos con función sistólica conservada y deprimida. Pacientes y método. Se incluyó a 1.252 pacientes, 767 varones (61,3%), ingresados con insuficiencia cardíaca en un servicio de cardiología de un hospital terciario. La mediana del seguimiento ha sido de 2,3 años, con una mortalidad total al final de los 12 años de seguimiento de un 41%. El 60,2% presentaba una fracción de eyección < 50%. Las mujeres tuvieron mayor edad (73,4 ± 10,0 frente a 66,8 ± 11,9 años; p < 0,001), mayor proporción de función sistólica conservada (el 52,2 frente al 31,9%; p < 0,001) y menor proporción de cardiopatía isquémica (el 44,1 frente al 53,2%; p < 0,001). Resultados. La influencia del sexo en el pronóstico no alcanzó significación estadística en el análisis multivariable en el grupo global (varón frente a mujer hazard ratio [HR] = 1,253; intervalo de confianza [IC] del 95%, 0,978-1,605; p = 0,074). Tampoco se objetivaron diferencias significativas en la supervivencia entre ambos sexos cuando se analizaron los subgrupos de función sistólica conservada y deprimida. Conclusiones. En nuestro estudio no observamos influencia significativa del sexo en la mortalidad de los pacientes hospitalizados por insuficiencia cardíaca ni tampoco en los subgrupos de función sistólica conservada y deprimida, a pesar de la tendencia hacia una mayor mortalidad en el grupo de los varones

Introduction and objectives. There is some controversy about the impact of sex on mortality in patients with heart failure. Moreover, little is known about its influence on prognosis in patients with preserved systolic function. The objective of this study was to investigate the influence of sex on survival in patients with heart failure, including subgroups with preserved or depressed left ventricular ejection fraction (LVEF). Patients and method. The study included 1252 patients (767 male, 61.3%) who were admitted with heart failure to the cardiology department of a tertiary hospital. The median follow-up period was 2.3 years, with the mortality rate rising to 41% after 12 years of follow-up. A LVEF less than 50% was observed in 60.2% of patients. Female patients were older (73.4 ± 10.0 years vs 66.8 ± 11.9 years; P<.001), a higher proportion had preserved systolic function (52.2% vs 31.9%; P<.001), and fewer had ischemic cardiopathy (44.1% vs 53.2%; P<.001).Results. In the group as a whole, the influence of sex on prognosis did not reach statistical significance: the hazard ratio in males compared with females was 1.253 (95%CI, 0.978-1.605; P=.074). In addition, no influence of sex on survival was observed in subgroups with preserved or depressed systolic function. Conclusions. In a large cohort, we did not observe any influence of sex on mortality in hospitalized patients with heart failure, either in the group as a whole or in subgroups with preserved or depressed left ventricular systolic function, despite a tendency towards higher mortality in males