The prognostic impact of gender in patients with acute heart failure - An evaluation of the age of female patients with severely decompensated acute heart failure.

BACKGROUND

The gender differences in the prognosis of Asian patients with acute heart failure (AHF) remain to be elucidated.

METHODS AND RESULTS

One thousand fifty AHF patients were enrolled. The patients were assigned to a female group (n=354) and a male group (n=696). A Kaplan-Meier curve showed that the cardiovascular survival rate of the female group was significantly lower than that of the male group (p=0.005). A multivariate Cox regression model identified female gender [hazard ratio (HR): 1.381, 95% CI: 1.018-1.872] as an independent predictor of 730-day cardiovascular death. In subgroup analysis by age, in patients over 79 years, female gender significantly increased the cardiovascular death (HR: 1.715, 95% CI: 1.088-2.074, p<0.001) with a significant interaction (p-value for interaction<0.001). The prognosis, including cardiovascular death, was significantly poorer among elderly female patients (≥79 years) than among elderly male patients (p=0.019). The multivariate Cox regression model identified female gender as an independent predictor of 730-day cardiovascular death in patients who were older than 79 years of age (HR, 1.943; 95% CI, 1.192-3.167).

CONCLUSIONS

Female gender was associated with poor prognosis in AHF patients. In particular, old age (≥79 years) was associated with adverse outcomes in female patients with AHF.