Clinical InvestigationCongestive Heart DiseaseRelation of sex to morbidity and mortality in patients with heart failure and reduced or preserved left ventricular ejection fraction
Section snippets
Patients and study design
This study was based on a retrospective analysis of patients enrolled in the DIG trial.11 Primary study outcomes were all-cause mortality and hospitalization for worsening heart failure, and secondary end points included all-cause hospitalization and cardiovascular hospitalization.
Statistical analysis
The principal statistical analysis of the study evaluated sex as an independent predictor of survival or risk of hospitalization for worsening heart failure in all patients and in both preserved and reduced ejection
Baseline characteristics
The clinical characteristics of the 7778 patients in the analysis are compared by sex and left ventricular ejection fraction group in Table I. Female sex was significantly more common in patients with preserved compared to reduced ejection fraction (41% vs 22%, P < .001). In both ejection fraction groups, women were significantly older, more likely to have a history of hypertension and diabetes, and less likely to have heart failure due to an ischemic etiology.
Study outcomes
In the overall study population,
Discussion
The major new findings of clinical importance in our study concern the association of sex with hospitalization in patients with chronic congestive heart failure. We found that women were less likely to be hospitalized for worsening heart failure than men in the overall study population. Because clinical characteristics (including the frequency of women) and pathophysiology differ between heart failure with reduced and preserved ejection fraction, we further analyzed the association between sex
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