Servicio de Cardiologia, Hospital Clínico Universitario Virgen de la Victoria de Málaga, Campus de Teatinos, Málaga, Spain.
Clin Cardiol. 2010 Mar;33(3):E13-8. doi: 10.1002/clc.20476.
Controversy exists concerning the influence of gender in the prognosis of patients with heart failure and no evidence is available from specific heart failure clinics.
Women with ambulatory heart failure are managed differently than men, although their prognosis might be better than men.
We analyzed the clinical characteristics, complementary test results, treatment, and prognosis in 4720 patients with chronic heart failure seen in 62 specialized clinics forming part of a multicenter registry during a mean follow-up of 40 months. The mean age was 65 +/- 12 years and 71% were men. The men were younger than the women and more often had a history of hyperlipidemia and ischemic heart disease. The men had a more advanced heart failure New York Heart Association (NYHA) functional class (III-IV) than the women and a greater frequency of systolic ventricular dysfunction. The men more often received treatment with beta-blockers, vasodilators, and antiplatelet aggregators as well as higher mean doses as compared with the women. The overall survival after the follow-up was similar for both genders, although the women had lower rates of survival free of admission for heart failure.
Despite the mortality of women and men with heart failure being similar, the rate of readmission for heart failure is greater in women in specialized heart failure clinics. These results may be associated with the pharmacological treatment differences observed.
关于性别对心力衰竭患者预后的影响存在争议，而特定心力衰竭诊所尚无相关证据。
与男性相比，女性慢性心力衰竭患者的管理方式可能有所不同，尽管其预后可能更好。
我们分析了 62 个专门诊所的多中心注册登记处中 4720 例慢性心力衰竭患者的临床特征、辅助检查结果、治疗和预后。平均随访 40 个月。患者平均年龄为 65±12 岁，71%为男性。男性比女性更年轻，且更常患有高脂血症和缺血性心脏病。男性心力衰竭纽约心脏协会（NYHA）功能分级（III-IV）较女性更为严重，且收缩性心室功能障碍更为常见。与女性相比，男性更常接受β受体阻滞剂、血管扩张剂和抗血小板聚集剂治疗，且平均剂量更高。随访后，男女的总体生存率相似，但女性心力衰竭再入院率较低。
尽管心力衰竭男女患者的死亡率相似，但在专门的心力衰竭诊所中，女性心力衰竭再入院率更高。这些结果可能与观察到的药物治疗差异有关。
