Abstract 13971: Gender Differences in Advanced Heart Failure Characteristics and Outcomes

Abstract

Introduction: The epidemiology and pathophysiology of heart failure (HF) differs in women and men. However, it is not well defined whether these differences extend to the subgroup of patients that develop advanced HF or if they translate to differences in outcomes. Aim: To compare the clinical characteristics and outcomes of advanced HF in women and men. Methods: This is a retrospective cohort study of all adult residents of Olmsted County, Minnesota with advanced HF (as defined by European Society of Cardiology Criteria) from 2007-2017. Differences in survival and hospitalization risks following advanced HF development in women and men were examined using Cox proportional hazard regression and Andersen Gill models, respectively. Results: Of 936 individuals with advanced HF, 417 (44.6%) were women and 519 (55.4%) were men. Women were older (mean 79 vs 75 years) with a lower overall comorbidity burden (Charlson comorbidity index 4.7 vs 5.2), less often had coronary artery disease (60% vs 79%) and hyperlipidemia (69% vs 77%), but more often had hypertension (91% vs 87%) and depression (32% vs 24%), and more often had advanced HF with preserved ejection fraction (60% vs. 30%) compared with men ( p<0.05 for each). After adjustment for age, ejection fraction and comorbidities, there were no differences in risks of survival or hospitalizations ( Figure ) between women and men (p> 0.10 for each). Conclusion: While advanced HF can occur in both women and men, their phenotypes differ; women more often present with advanced HFpEF and men with more atherosclerotic disease and advanced HFrEF. Despite these differences, survival is similar in women and men with advanced HF.