Journal article
Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry.
- Lainščak M Division of Cardiology, General Hospital Murska Sobota, Murska Sobota, Slovenia.
- Milinković I Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia.
- Polovina M Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia.
- Crespo-Leiro MG Unidad de Insuficiencia Cardiaca y Trasplante Cardiaco, Complexo Hospitalario Universitario A Coruna (CHUAC), INIBIC, UDC, CIBERCV, La Coruna, Spain.
- Lund LH Heart and Vascular Division, Department of Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
- Anker SD Division of Cardiology and Metabolism, Department of Cardiology, Berlin-Brandenburg Centre for Regenerative Therapies, Berlin, Germany.
- Laroche C EURObservational Research Programme, European Society of Cardiology, Sophia-Antipolis, France.
- Ferrari R Centro Cardiologico Universitario di Ferrara, University of Ferrara, Ferrara, Italy.
- Coats AJS Pharmacology Division, Centre of Clinical and Experimental Medicine, IRCCS San Raffaele Pisana, Rome, Italy.
- McDonagh T Faculty of Life Sciences and Medicine, King's College Hospital, London, UK.
- Filippatos G Department of Cardiology, Heart Failure Unit, Athens University Hospital Attikon, Athens, Greece.
- Maggioni AP EURObservational Research Programme, European Society of Cardiology, Sophia-Antipolis, France.
- Piepoli MF Heart Failure Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy.
- Rosano GMC Cardiovascular and Cell Sciences Institute, King's College Hospital, London, UK.
- Ruschitzka F Clinic of Cardiology, University Hospital, Zurich, Switzerland.
- Simić D Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia.
- Ašanin M Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia.
- Eicher JC Department of Cardiology, Rhythmology and Heart Failure Unit, University Hospital François Mitterrand, Dijon, France.
- Yilmaz MB Department of Cardiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
- Seferović PM Faculty of Medicine, Belgrade University, Belgrade, Serbia.
- 2019-12-22
Published in:
- European journal of heart failure. - 2020
English
AIMS
This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients.
METHODS AND RESULTS
Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P ≤ 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P = 0.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P < 0.001) and there were no differences in causes of death. All-cause mortality and all-cause hospitalization increased with greater age in both sexes. Sex was not an independent predictor of 1-year all-cause mortality (restricted to patients with LVEF ≤45%). Mortality risk was significantly lower in patients of younger age, compared to patients aged >75 years.
CONCLUSIONS
There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF ≤45%.
This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients.
METHODS AND RESULTS
Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P ≤ 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P = 0.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P < 0.001) and there were no differences in causes of death. All-cause mortality and all-cause hospitalization increased with greater age in both sexes. Sex was not an independent predictor of 1-year all-cause mortality (restricted to patients with LVEF ≤45%). Mortality risk was significantly lower in patients of younger age, compared to patients aged >75 years.
CONCLUSIONS
There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF ≤45%.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1002/ejhf.1645
- PMID 31863522
- Persistent URL
- https://folia.unifr.ch/global/documents/48332
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