Varela Román Alfonso, Grigorian Shamagian Lilian, Bandín Diéguez Manuel A, Rigueiro Veloso Pedro, González-Juanatey José R
Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, A Coruña, Spain.
Rev Esp Cardiol. 2005 Oct;58(10):1171-80.
There is some controversy about the impact of sex on mortality in patients with heart failure. Moreover, little is known about its influence on prognosis in patients with preserved systolic function. The objective of this study was to investigate the influence of sex on survival in patients with heart failure, including subgroups with preserved or depressed left ventricular ejection fraction (LVEF).
The study included 1252 patients (767 male, 61.3%) who were admitted with heart failure to the cardiology department of a tertiary hospital. The median follow-up period was 2.3 years, with the mortality rate rising to 41% after 12 years of follow-up. A LVEF less than 50% was observed in 60.2% of patients. Female patients were older (73.4 +/- 10.0 years vs 66.8 +/- 11.9 years; P < .001), a higher proportion had preserved systolic function (52.2% vs 31.9%; P < .001), and fewer had ischemic cardiopathy (44.1% vs 53.2%; P < .001).
In the group as a whole, the influence of sex on prognosis did not reach statistical significance: the hazard ratio in males compared with females was 1.253 (95%CI, 0.978-1.605; P = .074). In addition, no influence of sex on survival was observed in subgroups with preserved or depressed systolic function.
In a large cohort, we did not observe any influence of sex on mortality in hospitalized patients with heart failure, either in the group as a whole or in subgroups with preserved or depressed left ventricular systolic function, despite a tendency towards higher mortality in males.
关于性别对心力衰竭患者死亡率的影响存在一些争议。此外,对于其对收缩功能保留患者预后的影响知之甚少。本研究的目的是调查性别对心力衰竭患者生存的影响,包括左心室射血分数(LVEF)保留或降低的亚组。
该研究纳入了1252例因心力衰竭入住三级医院心内科的患者(767例男性,占61.3%)。中位随访期为2.3年,随访12年后死亡率升至41%。60.2%的患者左心室射血分数低于50%。女性患者年龄更大(73.4±10.0岁对66.8±11.9岁;P<.001),收缩功能保留的比例更高(52.2%对31.9%;P<.001),缺血性心脏病患者更少(44.1%对53.2%;P<.001)。
在整个组中,性别对预后的影响未达到统计学意义:男性与女性相比的风险比为1.253(95%CI,0.978 - 1.605;P = 0.074)。此外,在收缩功能保留或降低的亚组中未观察到性别对生存的影响。
在一个大型队列中,我们未观察到性别对住院心力衰竭患者死亡率有任何影响,无论是在整个组中还是在左心室收缩功能保留或降低的亚组中,尽管男性有更高死亡率的趋势。