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Gender difference in the impact of Ischaemic heart disease on heart failure

Authors
 Hyun-Jin Kim  ;  Myung-A Kim  ;  Hack-Lyoung Kim  ;  Dong-Ju Choi  ;  Seongwoo Han  ;  Eun-Seok Jeon  ;  Myeong-Chan Cho  ;  Jae-Joong Kim  ;  Byung-Su Yoo  ;  Mi-Seung Shin  ;  Seok-Min Kang  ;  Shung Chull Chae 
Citation
 EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Vol.50(5) : e13232, 2020-05 
Journal Title
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
ISSN
 0014-2972 
Issue Date
2020-05
MeSH
Aged ; Aged, 80 and over ; Cause of Death ; Comorbidity ; Female ; Heart Failure / epidemiology* ; Heart Failure / physiopathology ; Humans ; Male ; Middle Aged ; Mortality* ; Myocardial Ischemia / epidemiology* ; Odds Ratio ; Prognosis ; Proportional Hazards Models ; Registries ; Republic of Korea / epidemiology ; Sex Factors ; Stroke Volume*
Keywords
ejection fraction ; gender ; heart failure ; ischaemic heart disease
Abstract
Background: Although the impact of ischaemic heart disease (IHD) on heart failure (HF) is evolving, there is uncertainty about the role of IHD in determining the risk of clinical outcomes by gender. This study evaluated the gender difference in the impact of IHD on long-term clinical outcomes in patients with heart failure reduced ejection fraction (HFrEF).

Methods: Study data were obtained from a nationwide registry, which is a prospective multicentre cohort that included 3200 patients who were hospitalized for HF. A total of 1638 patients with HFrEF were classified by gender. The primary outcome was all-cause death during follow-up.

Results: In total, 133 women (18.9%) died and 168 men (18.0%) died during the follow-up (median, 489 days). Women with HFrEF with IHD had a significantly lower cumulative survival rate than women without IHD at the long-term follow-up (74.8% vs 84.9%, log-rank P = .001). However, the survival rate was not different in men with HFrEF with IHD compared with men without IHD. A Cox regression analysis showed that IHD had a 1.43-fold increased risk for all-cause mortality independently in women after adjusting for confounding factors (odds ratio 1.43, 95% confidence interval 1.058-1.929, P = .020).

Conclusion: Ischaemic heart disease was an independent risk factor for long-term mortality in women with HFrEF. IHD should be actively evaluated in women with HF for predicting clinical outcomes and initiating appropriate treatment. Women with HF caused by IHD should be treated more meticulously to avoid a poor prognosis.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1111/eci.13232
DOI
10.1111/eci.13232
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182747
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