Abstract 13620: Different Outcomes Influenced by Physical Frailty: A Comparison Between Women and Men With Heart Failure

Abstract

Introduction: Physical frailty is strongly related to adverse outcomes in heart failure (HF), including greater adverse clinical event risk and poor quality-of-life. In HF, women are more likely to be physically frail than men, but little is known about how this sex difference affects outcomes. The purpose of this study was to quantify sex differences in the associations between physical frailty and clinical and quality-of-life outcomes in HF. Methods: This was a prospective study of adults with NYHA Functional Class I-IV HF. A formal assessment of physical frailty was performed using the Frailty Phenotype Criteria; scores range from 0-5. Clinical characteristic data specific to the Seattle HF Model score (SHFM) were collected to account for the severity and treatment of HF. Clinical events (all-cause death, emergency room visit, or hospitalization for cardiovascular cause) over 12 months were adjudicated. Health-related quality-of-life was assessed using the Minnesota Living with HF Questionnaire (MLHFQ). Sex-stratified Cox regression analysis was used to examine associations between physical frailty and clinical events. Sex-stratified generalized linear modeling was used to examine associations between physical frailty and MLHFQ scores. Results: The sample (n = 115) was 63.5±15.7 years old, 49% women, and 29% had HF with preserved EF. After adjusting for SHFM scores, continuous physical frailty scores were significantly associated with time to first clinical event among men but not women. Specifically, for every one point increase in physical frailty score, there was a 46% higher risk of experiencing an event among men (HR = 1.46 [1.00, 2.11], p = 0.047) but not women (HR = 1.21 [0.81, 1.81], p = 0.36). After adjusting for SHFM scores, physical frailty was associated with 89% worse MLHFQ scores among women (p = 0.005) but was not significantly associated with MLHFQ scores among men (p = 0.14). Conclusions: This study demonstrates that physical frailty in HF may be predominantly associated with worse clinical event risk among men and worse quality-of-life among women.