Sex differences in clinical characteristics and long‐term clinical outcomes in Asian hospitalized heart failure patients

Abstract

Abstract Aims Sex differences in long‐term post‐discharge clinical outcomes in Asian patients hospitalized for acute decompensated heart failure (HF) persist despite the world‐wide implementation of guideline‐directed medical therapy for decades. The present study aims to elucidate the puzzling dilemma and to depict the directions of solution. Methods and results Between 2011 and 2020, a total of 12 428 patients (6518 men and 5910 women, mean age 73.50 ± 14.85) hospitalized for acute decompensated HF were retrospectively enrolled from a university HF cohort. Compared with men, women hospitalized for acute decompensated HF were older in age (76.40 ± 13.43 vs. 71.20 ± 15.67 years old, P 50%) than men (P 50%) and HF with mildly reduced EF (40%–50%), but not in HF with reduced EF (<40%) category. Subgroup forest plot analysis showed body mass index, coexisting hypertension and chronic obstructive pulmonary disease as significant interacting factors. Conclusions With more coronary risk factors and medical comorbidities, less cardiac remodelling and better adherence to guideline‐directed HF therapy, women hospitalized for acute decompensated HF demonstrated superiority over men in long‐term post‐discharge clinical outcomes, including all‐cause mortality, cardiovascular mortality and 1 year mortality, and mainly in HF with preserved and mid‐range EF categories, in the Asian HF cohort.

Keywords

• cohort study
• heart failure
• women