, Ümit Yaşar Sinan 2
, Dogaç Çağlar Gürbüz 3
, Özgen Şafak 4
, Hakkı Kaya 5
, Ümit Yüksek 6
, Mehdi Zoghi 7
2Department of Cardiology, Faculty of Medicine, İstanbul University Cerrahpaşa Institute of Cardiology, İstanbul, Türkiye
3Department of Cardiology, Faculty of Medicine, Koç University, İstanbul, Türkiye
4Department of Cardiology, Faculty of Medicine, Balıkesir University, Balıkesir, Türkiye
5Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
6Department of Cardiology, Ödemiş State Hospital, İzmir, Türkiye
7Department of Cardiology, Faculty of Medicine, Ege University, İzmir, Türkiye
Abstract
Background: Gender-related clinical variations in patients with acute heart failure have been described in previous studies. However, there is still a lack of research on gender differences in patients hospitalized for acute heart failure in Türkiye. The aim of this study is to compare the clinical features, in-hospital approaches, and outcomes of male and female patients hospitalized for acute heart failure.
Materials and Methods: Differences in clinical characteristics, medication prescription, hospital management, and outcomes between males and females with acute heart failure were investigated from the Journey Heart Failure—Turkish Population study.
Results: Nine hundred eighteen patients (57.2%) were men and 688 (42.8%) were women. Women were older than men (70.48 ± 13.20 years vs. 65.87 ± 12.82 years; P <.001). The frequency of comorbidities such as hypertension (72.7% vs. 62.4%, P <.001), diabetes (46.5% vs. 38.5%, P = .001), atrial fibrillation (46.5% vs. 33.4%, P <.001), New York Heart Association class III-IV symptoms (80.6% vs. 71.2%, P =.001), and dyspnea in the rest (73.8% vs. 68.3%, P =.044) were more common in women on admission. Male patients were more frequently hospitalized with reduced left ventricular ejection fraction (51.0% vs. 72.4%, P <.001). In-hospital mortality was higher among female patients (9.3% vs. 6.4%, P =.022). Higher New York Heart Association class, lower estimated glomerular filtration rate, higher N-terminal pro-B type natriuretic peptide on admission, and mechanical ventilation usage were the independent parameters of in-hospital mortality, whereas the female gender was not.
Conclusion: Our study clearly demonstrated the diversity in presentation, management, and in-hospital outcomes of acute heart failure between male and female patients. Although left ventricular systolic functions were better in female patients, in-hospital mortality was higher. Recognizing these differences in the management of heart failure in different sexes will serve better results in clinical practice.