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Anatol J Cardiol. 2019 Apr;21(5):242-252. doi: 10.14744/AnatolJCardiol.2019.71954.

Gender disparities in heart failure with mid-range and preserved ejection fraction: Results from APOLLON study.

Author information

1
Department of Cardiology, Muğla Sıtkı Koçman University Training and Research Hospital; Muğla-Turkey.
2
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey.
3
Department of Cardiology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş-Turkey.
4
Department of Cardiology, Mehmet Akif İnan Training and Research Hospital; Şanlıurfa-Turkey.
5
Department of Cardiology, Faculty of Medicine, Kafkas University; Kars-Turkey.
6
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey.
7
Department of Cardiology, Hitit University Çorum Erol Olçok Training and Research Hospital; Çorum-Turkey.
8
Department of Cardiology, Faculty of Medicine, Bülent Ecevit Universiy; Zonguldak-Turkey.
9
Department of Cardiology, Kırıkkale Yüksek İhtisas Hospital; Kırıkkale-Turkey.
10
Department of Cardiology, Faculty of Medicine, Eskişehir Osmangazi University; Eskişehir-Turkey.
11
Department of Cardiology, Yunus Emre State Hospital; Eskişehir-Turkey.

Abstract

OBJECTIVE:

This study aimed to examine gender-based differences in epidemiology, clinical characteristics, and management of consecutive patients with heart failure with mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF).

METHODS:

The APOLLON trial (A comPrehensive, ObservationaL registry of heart faiLure with mid-range and preserved ejection fractiON) is a multicenter, cross-sectional, and observational study. Consecutive patients with HFmrEF or HFpEF who were admitted to the cardiology clinics were included (NCT03026114). Herein, we performed a post-hoc analysis of data from the APOLLON trial.

RESULTS:

The study population included 1065 (mean age of 67.1+-10.6 years, 54% women) patients from 11 sites in Turkey. Compared with men, women were older (68 years vs. 67 years, p<0.001), had higher body mass index (29 kg/m2 vs. 27 kg/m2, p<0.001), and had higher heart rate (80 bpm vs. 77.5 bpm, p<0.001). Women were more likely to have HFpEF (82% vs. 70.9%, p<0.001), and they differ from men having a higher prevalence of hypertension (78.7% vs. 73.2%, p=0.035) and atrial fibrillation (40.7% vs. 29.9%, p<0.001) but lower prevalence of coronary artery disease (29.5% vs. 54.9%, p<0.001). Women had higher N-terminal pro-B-type natriuretic peptide (691 pg/mL vs. 541 pg/mL, p=0.004), lower hemoglobin (12.7 g/dL vs. 13.8 g/dL, p<0.001), and serum ferritin (51 ng/mL vs. 64 ng/mL, p=0.001) levels, and they had worse diastolic function (E/e'=10 vs. 9, p<0.001). The main cause of heart failure (HF) in women was atrial fibrillation, while it was ischemic heart disease in men.

CONCLUSION:

Clinical characteristics, laboratory findings, and etiological factors are significantly different in female and male patients with HFmrEF and HFpEF. This study offers a broad perspective for increased awareness about this patient profile in Turkey.

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