Gender Disparity in Acute Heart Failure: Insights from Korean Acute Heart Failure (KorAHF) Registry

Abstract

Objectives This study aimed to determine the influences of the gender on baseline characteristics, management, and prognosis in acute heart failure. Backgrounds Relatively little attention has focused on the gender-related differences in heart failure and women have been underrepresented in clinical trials. Methods We evaluated the patients hospitalized for acute heart failure in 10 tertiary university hospitals who registered in the Korean Acute Heart Failure (KorAHF) Registry from March 2011 to February 2014. Results We analyzed 5,625 patients (2,632 females). Mean age was 69±14 years old and females were older. Hypertension and valvular heart disease were more prevalent in females, whereas ischemic heart diseases and chronic kidney disease were more prevalent in males. Although females were more severely symptomatic, they were treated in the intensive care unit less frequently and the use of renal replacement therapy, mechanical ventilation and mechanical assist device was low in the female group. During follow-up (29.6±19.2 months), 2,196 patients expired including 269 in-hospital mortality. In the univariate analysis, female gender was not a significant determinant. However, after adjustment of variable factors influencing long-term survival, female gender was a significant prognosticator of the long-term survival [hazard ratio=0.749, 95% confidential interval=0.647-0.867, P Conclusions There are significant gender-related differences in baseline characteristics, clinical presentation, treatment and prognosis in patients with AHF. After the adjustment of multiple factors affecting long-term survival, females had better survival rate than males.