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急性心力衰竭患者的性别相关差异。欧洲心力衰竭调查II的结果。

Gender related differences in patients presenting with acute heart failure. Results from EuroHeart Failure Survey II.

作者信息

Nieminen Markku S, Harjola Veli-Pekka, Hochadel Matthias, Drexler Helmut, Komajda Michel, Brutsaert Dirk, Dickstein Kenneth, Ponikowski Piotr, Tavazzi Luigi, Follath Ferenc, Lopez-Sendon Jose Luis

机构信息

Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Finland.

出版信息

Eur J Heart Fail. 2008 Feb;10(2):140-8. doi: 10.1016/j.ejheart.2007.12.012.

Abstract

AIMS

This analysis evaluates the gender differences in patients hospitalised for acute heart failure (AHF) in the EuroHeart Failure Survey II (EHFS).

RESULTS

Of the 3580 patients included in EHFS II, 1384 (39%) were women, mean age 73 years. 2196 (61%) were men, mean age 68 years. Women more frequently had new-onset AHF, hypertension and valvular disease and less frequently coronary heart disease or dilated cardiomyopathy compared with men. Smoking, chronic obstructive pulmonary disease, peripheral arterial disease and renal failure were less common, but diabetes and anaemia significantly more frequent in women. Atrial fibrillation and preserved left ventricular function were more common in women. Men were more often non-compliant with medication. After adjustment for indications and age, there were no significant gender differences in prescription of HF medication. All-cause readmission rate during the one-year follow-up was lower in women. However, the proportion of HF hospitalisation and one-year mortality after discharge (20%) were similar in both genders.

CONCLUSION

Women frequently present with new-onset AHF. A significant gender difference exists in aetiology, ventricular function and co-morbidities. Women's use of HF medication has improved. These findings emphasize the importance of individualised management and need for more comprehensive recruitment of women in clinical trials.

摘要

目的

本分析评估了欧洲心力衰竭调查II(EHFS)中因急性心力衰竭(AHF)住院患者的性别差异。

结果

在EHFS II纳入的3580例患者中,1384例(39%)为女性,平均年龄73岁。2196例(61%)为男性,平均年龄68岁。与男性相比,女性新发AHF、高血压和瓣膜病更为常见,而冠心病或扩张型心肌病则较少见。吸烟、慢性阻塞性肺疾病、外周动脉疾病和肾衰竭在女性中较少见,但糖尿病和贫血在女性中明显更为常见。心房颤动和左心室功能保留在女性中更为常见。男性更常不遵医嘱用药。在调整适应证和年龄后,心力衰竭药物处方方面不存在显著的性别差异。女性在一年随访期间的全因再入院率较低。然而,心力衰竭住院比例和出院后一年死亡率(20%)在两性中相似。

结论

女性常表现为新发AHF。在病因、心室功能和合并症方面存在显著的性别差异。女性对心力衰竭药物的使用有所改善。这些发现强调了个体化管理的重要性以及在临床试验中更全面招募女性的必要性。

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