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J Am Coll Cardiol. 1996 Dec;28(7):1781-8.

Relation between gender, etiology and survival in patients with symptomatic heart failure.

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1
Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill 27599-7075, USA.

Abstract

OBJECTIVES:

This study investigated the relation between gender, etiology and survival in patients with symptomatic heart failure.

BACKGROUND:

Previous work provides conflicting results concerning the relation between gender, clinical characteristics and survival in patients with heart failure.

METHODS:

We examined the relation of these factors in 557 patients (380 men, 177 women) who had symptomatic heart failure, predominantly nonischemic in origin (68%) and typically associated with severe left ventricular dysfunction.

RESULTS:

Follow-up data were available in 99% of patients (mean follow-up period 2.4 years, range 1 day to 10 years) after study entry, and 201 patients reached the primary study end point of all-cause mortality. By life-table analysis, women were significantly less likely to reach this primary end point than men (p < 0.001). A significant association was found between female gender and better survival (p < 0.001), which depended on the primary etiology of heart failure (p = 0.008 for the gender-etiology interaction) but not on baseline ventricular function. Women survived longer than men when heart failure was due to nonischemic causes (men vs. women: relative risk [RR] 2.36, 95% confidence interval [CI] 1.59 to 3.51, p < 0.001). In contrast, outcome appeared similar when heart failure was due to ischemic heart disease (men vs. women: RR 0.85, 95% CI 0.45 to 1.61, p = 0.651).

CONCLUSIONS:

Women with heart failure due to nonischemic causes had significantly better survival than men with or without coronary disease as their primary cause of heart failure.

PMID:
8962567
DOI:
10.1016/S0735-1097(96)00380-4
[Indexed for MEDLINE]
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