Female gender is associated with a worse prognosis amongst patients hospitalised for de-novo acute heart failure.

Abstract

Recent evidence showed that new-onset (de-novo) acute heart failure (AHF) is a distinct type of AHF. However, the prognostic implication of gender on these patients remains unclear. We aimed to investigate the impact of gender on both short and long-term mortality outcomes after hospitalisation for de-novo AHF. We analysed the data of 721 patients with de-novo AHF, who were enrolled in the HF survey in Israel between March and April 2003 and were followed until December 2014. Fifty-four percent (N=387) of the patients were men. In comparison to women, men patients were more likely to be younger, smokers, and with ischemic HF aetiology. At 30days, mortality rates were higher in women (12% vs 7%, P=.013). Survival analysis showed that at 1 and 10years the all-cause mortality rates were significantly higher in women (28% vs 17%, and 78% vs 67%, 1 and 10years, P<.001, respectively). Consistently, multivariable analysis showed that women had an independently 82% and 24% higher mortality risk at 1 and 10years, respectively, (1-year hazard ratio=1.82; 95% confidence interval=1.07 to 3.11, P=.03; 10-year hazard ratio=1.24; 95% confidence interval=1.03 to 1.48, P=.02). Amongst patients with de-novo AHF, women had higher mortality rates compared with men. The observed gender-related differences in de-novo AHF patients highlight the need for further and deeper research in this field.