Gender difference in the impact of Ischaemic heart disease on heart failure
Hyun-Jin Kim
Cardiovascular center, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
Search for more papers by this authorCorresponding Author
Myung-A Kim
Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Korea
Correspondence
Myung-A Kim, Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, 20 Boramae-ro-5-gil, Dongjak-gu, Seoul 07061, Korea.
Email: [email protected]
Search for more papers by this authorHack-Lyoung Kim
Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Korea
Search for more papers by this authorDong-Ju Choi
Department of Internal Medicine, Seoul National University College of Medicine, Bundang Hospital, Seongnam, Korea
Search for more papers by this authorSeongwoo Han
Department of Cardiovascular Medicine, College of Medicine, Dongtan Sacred Heart Hospital, Hallym University, Hwasung, Korea
Search for more papers by this authorEun-Seok Jeon
Department of Internal Medicine, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea
Search for more papers by this authorMyeong-Chan Cho
Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
Search for more papers by this authorJae-Joong Kim
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Search for more papers by this authorByung-Su Yoo
Department of Internal Medicine, Yonsei University Wonju Christian Hospital, Wonju, Korea
Search for more papers by this authorMi-Seung Shin
Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea
Search for more papers by this authorSeok-Min Kang
Department of Internal Medicine, Yonsei University Severance Hospital, Seoul, Korea
Search for more papers by this authorShung Chull Chae
Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Korea
Search for more papers by this authorHyun-Jin Kim
Cardiovascular center, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
Search for more papers by this authorCorresponding Author
Myung-A Kim
Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Korea
Correspondence
Myung-A Kim, Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, 20 Boramae-ro-5-gil, Dongjak-gu, Seoul 07061, Korea.
Email: [email protected]
Search for more papers by this authorHack-Lyoung Kim
Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Korea
Search for more papers by this authorDong-Ju Choi
Department of Internal Medicine, Seoul National University College of Medicine, Bundang Hospital, Seongnam, Korea
Search for more papers by this authorSeongwoo Han
Department of Cardiovascular Medicine, College of Medicine, Dongtan Sacred Heart Hospital, Hallym University, Hwasung, Korea
Search for more papers by this authorEun-Seok Jeon
Department of Internal Medicine, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea
Search for more papers by this authorMyeong-Chan Cho
Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
Search for more papers by this authorJae-Joong Kim
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Search for more papers by this authorByung-Su Yoo
Department of Internal Medicine, Yonsei University Wonju Christian Hospital, Wonju, Korea
Search for more papers by this authorMi-Seung Shin
Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea
Search for more papers by this authorSeok-Min Kang
Department of Internal Medicine, Yonsei University Severance Hospital, Seoul, Korea
Search for more papers by this authorShung Chull Chae
Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Korea
Search for more papers by this authorAbstract
Background
Although the impact of ischaemic heart disease (IHD) on heart failure (HF) is evolving, there is uncertainty about the role of IHD in determining the risk of clinical outcomes by gender. This study evaluated the gender difference in the impact of IHD on long-term clinical outcomes in patients with heart failure reduced ejection fraction (HFrEF).
Methods
Study data were obtained from a nationwide registry, which is a prospective multicentre cohort that included 3200 patients who were hospitalized for HF. A total of 1638 patients with HFrEF were classified by gender. The primary outcome was all-cause death during follow-up.
Results
In total, 133 women (18.9%) died and 168 men (18.0%) died during the follow-up (median, 489 days). Women with HFrEF with IHD had a significantly lower cumulative survival rate than women without IHD at the long-term follow-up (74.8% vs 84.9%, log-rank P = .001). However, the survival rate was not different in men with HFrEF with IHD compared with men without IHD. A Cox regression analysis showed that IHD had a 1.43-fold increased risk for all-cause mortality independently in women after adjusting for confounding factors (odds ratio 1.43, 95% confidence interval 1.058-1.929, P = .020).
Conclusion
Ischaemic heart disease was an independent risk factor for long-term mortality in women with HFrEF. IHD should be actively evaluated in women with HF for predicting clinical outcomes and initiating appropriate treatment. Women with HF caused by IHD should be treated more meticulously to avoid a poor prognosis.
CONFLICTS OF INTEREST
None declared.
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