Sex Differences in Patients With Acute Decompensated Heart Failure: Insights From the Heart Function Assessment Registry Trial in Saudi Arabia
Sex Differences in Patients With Acute Decompensated Heart Failure: Insights From the Heart Function Assessment Registry Trial in Saudi Arabia
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DOI：
10.1177/0003319715607298
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发表时间：
2016-08-01
期刊：
影响因子：
2.8
通讯作者：
Al Habib, Khalid F.
中科院分区：
文献类型：
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作者：
AlFaleh, Hussam F.;Thalib, Lukman;Al Habib, Khalid F.
我们评估了急性心力衰竭（AHF）患者临床特征和结局的性别差异。沙特阿拉伯的心功能评估登记试验（HEARTS）是一项前瞻性登记试验，在2009年至2010年期间招募了2609名AHF患者（34.2%为女性）。女性年龄较大，更有可能有动脉粥样硬化、心力衰竭（HF）史、风湿性心脏和瓣膜疾病的危险因素。缺血性心脏病是男性和女性发生HF的主要原因，但男性发生率更高（P < 0.001）。女性高血压心脏病和原发性瓣膜疾病的发生率较高（P < 0.001）。男性更有可能出现严重的左心室收缩功能障碍。出院时，男性使用血管紧张素转换酶抑制剂、受体阻滞剂和醛固酮抑制剂的比例较高（所有比较P < 0.001）。除了女性较高的房颤和男性较高的室性心律失常外，在医院结果中没有观察到差异。男性和女性的总生存率无差异（风险比：1.0,95%可信区间：0.8-1.2,P = .981）。AHF的男性和女性在基线临床特征和管理方面有显著差异，但在不良结局方面无显著差异。
We assessed sex-specific differences in clinical features and outcomes of patients with acute heart failure (AHF). The Heart function Assessment Registry Trial in Saudi Arabia (HEARTS), a prospective registry, enrolled 2609 patients with AHF (34.2% women) between 2009 and 2010. Women were older and more likely to have risk factors for atherosclerosis, history of heart failure (HF), and rheumatic heart and valve disease. Ischemic heart disease was the prime cause for HF in men and women but more so in men (P < .001). Women had higher rates of hypertensive heart disease and primary valve disease (P < .001, for both comparisons). Men were more likely to have severe left ventricular systolic dysfunction. On discharge, a higher use of angiotensin-converting enzyme inhibitors, -blockers, and aldosterone inhibitors was observed in men (P < .001 for all comparisons). Apart from higher atrial fibrillation in women and higher ventricular arrhythmias in men, no differences were observed in hospital outcomes. The overall survival did not differ between men and women (hazard ratio: 1.0, 95% confidence interval: 0.8-1.2, P = .981). Men and women with AHF differ significantly in baseline clinical characteristics and management but not in adverse outcomes.