急性心力衰竭中性别差异重要吗？来自印度心脏病学会-印度国家心力衰竭注册研究的见解。
Do gender differences matter in Acute Heart Failure? Insights from Indian College of Cardiology - National Heart Failure Registry, India.
作者信息
Jayagopal P B, Manjunath C N, Jabir A, Sastry Sridhar L, Nanjappa Veena, Vaidyanathan P R, Joseph Johny, Ghanta Soma Sekhar, Manokar P, Kabra Nitin, Jain Dharmendra, Sharma Vinod, Mishra Trinath Kumar, Badri Narayanan R, Jathappa Narendra, Rege Gautam, Modi Sunil, Routray S N, Raghu T R, Chakraborty Rabin, Rao Dayasagar, Sengupta Shantanu, Ravindranath K S, Srinivas B C, Chopra V K
机构信息
Lakshmi Hospital, Chittur Road, Palakkad, Kerala, 678013, India.
Sri Jayadeva Institute of Cardiovascular Sciences & Research, Kumbarakoppal, Vijay Nagar, Gokulam 3rd Stage, Mahadeshwara Badavane Layout, Mysuru, Karnataka, 570016, India.
出版信息
Int J Cardiol Cardiovasc Risk Prev. 2025 May 24;26:200441. doi: 10.1016/j.ijcrp.2025.200441. eCollection 2025 Sep.
BACKGROUND
Real-world investigations focused on gender-associated characteristics of Acute Heart failure (AHF) are lacking. The current study, from a national heart failure registry, aims to investigate gender-based patterns and outcomes among AHF patients in India.
METHODS
This prospective Indian College of Cardiology National Heart Failure Registry enrolled patients admitted with AHF in 17 centres from 2019 to 2021. Demographics, aetiology, co-morbidities, laboratory investigations, electrocardiogram, and echo parameters were captured. In-hospital 30-day and one-year mortality rates were recorded. The prescription and adherence to the three Guideline Directed Medical Therapy (GDMT) prescription in 2019-2021 were also captured at discharge. Mortality rate Gender-based comparisons were tested at a 5 % level of significance.
RESULTS
The study enrolled 5182 AHF patients, 66.7 % male (M) and 33.3 % female (F). The mean age of the male (M) population was 60.9 ± 13.3, and the female (F) population was 62.8 ± 14 years. Women had a higher prevalence of heart failure with preserved ejection fraction (HFpEF)(F:12.9 %, M:7.3 %; < 0.0001), hypertension (F: 57.2 %, M: 52.4 %; = 0.0011) and arrhythmia (F:15.2 %, M:11.7 %; = 0.0005). Men had a higher incidence of ischemic heart disease (M:76.2 %, F:67.5 %; < 0.001). Adherence to Renin-angiotensin-aldosterone system (RAAS) inhibitors, Beta-blockers and Mineralocorticoid receptor antagonists (MRAs) was low (18.8 % (M); 15.9 % (F)). The mortality rate, in-hospital mortality was 6.9 % (M:6.5 %, F:7.7 %), up to one-month was 11.8 % (M:11.6 %, F:12.3 %) or one-year was 18.1 % (M:17.8 %, F:18.6 %).
CONCLUSION
Women represent one-third of the population with AHF. Hypertension and HFpEF were more common in women, while ischemic heart disease was more prevalent in men. No gender-based differences were observed in the mortality outcomes. Both groups had low GDMT adherence. This calls for effective strategies to improve HF care in the country.
背景
缺乏针对急性心力衰竭（AHF）性别相关特征的真实世界研究。本项来自全国心力衰竭登记处的研究旨在调查印度AHF患者基于性别的模式和结局。
方法
这项前瞻性的印度心脏病学会全国心力衰竭登记研究纳入了2019年至2021年在17个中心因AHF入院的患者。记录了人口统计学、病因、合并症、实验室检查、心电图和超声心动图参数。记录了住院30天和1年的死亡率。还记录了2019 - 2021年出院时三种指南指导药物治疗（GDMT）处方的开具和依从情况。死亡率的性别比较在5%的显著性水平上进行检验。
结果
该研究纳入了5182例AHF患者，男性占66.7%，女性占33.3%。男性人群的平均年龄为60.9±13.3岁，女性人群为62.8±14岁。女性射血分数保留的心力衰竭（HFpEF）患病率更高（女性：12.9%，男性：7.3%；<0.0001）、高血压（女性：57.2%，男性：52.4%；=0.0011）和心律失常（女性：15.2%，男性：11.7%；=0.0005）。男性缺血性心脏病的发病率更高（男性：76.2%，女性：67.5%；<0.001）。肾素 - 血管紧张素 - 醛固酮系统（RAAS）抑制剂、β受体阻滞剂和盐皮质激素受体拮抗剂（MRAs）的依从性较低（男性为18.8%；女性为15.9%）。死亡率方面，住院死亡率为6.9%（男性：6.5%，女性：7.7%），1个月时为11.8%（男性：11.6%，女性：12.3%），1年时为18.1%（男性：17.8%，女性：18.6%）。
结论
女性占AHF患者人群的三分之一。高血压和HFpEF在女性中更常见，而缺血性心脏病在男性中更普遍。在死亡率结局方面未观察到基于性别的差异。两组的GDMT依从性均较低。这需要有效的策略来改善该国的心力衰竭护理。
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