GENDER DIFFERENCES IN BASELINE CHARACTERISTICS, QUALITY OF CARE MEASURES, AND OUTCOMES AMONG PATIENTS HOSPITALIZED WITH ACUTE DECOMPENSATED HEART FAILURE IN ASIA-PACIFIC AND LATIN AMERICA REGIONS: ANALYSIS OF THE ACUTE DECOMPENSATED HEART FAILURE INTERNATIONAL REGISTRY (ADHERE-INTERNATIONAL)

Abstract

Background: There are limited data on gender differences among patients presenting with acute decompensated heart failure (ADHF) outside the North American and European regions.Methods: The ADHERE-International registry consists of 9702 ADHF admissions from 70 hospitals in the Asia Pacific and Latin America regions from 2005-9. We compared the characteristics, quality of care (QOC) measures, and in-hospital outcomes between genders. The impact of gender was assessed with multivariable regression model, using generalized estimating equations to account for within hospital clustering.Results: Females accounted for 42% of the cohort. Baseline characteristics differ between genders (Table). Females were less likely to be prescribed angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB), beta-blocker, and diuretics both on admission and upon discharge. After adjusting for patients’ characteristics, there were no differences between gender for in-hospital outcomes and QOC measures, except a modest association of male gender with the use of ACEi or ARB in patients with systolic impairment (Adjusted OR 1.14; 95% CI 1.00-1.29, P=0.048).Conclusions: There are gender differences in patient characteristics, therapies, and QOC measures among ADHF admissions in Asian Pacific and Latin American countries, which are largely accounted for based on differences in age and baseline characteristics and were not associated with gender differences for in-hospital outcomes.