SPC365

Heart Failure disparities by sex: a comparative analysis of a real-world population followed in a regional hospital

Session: Sessão de Posters 57 - Diferenças de género em Cardiologia
Speaker: Adriana da Fonseca Vazão

Congress: CPC 2024
Topic: J. Preventive Cardiology
Theme: 28. Risk Factors and Prevention
Subtheme: 28.14 Risk Factors and Prevention - Other
Session Type: Cartazes
FP Number: ---
Authors: Adriana Vazão; Carolina Gonçalves; André Martins; Mariana Carvalho; Margarida Cabral; João Carvalho; Célia Domingues; Joana Correia; João Morais

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:&quot;PT Serif&quot;,serif"><span style="color:#222222">Introduction: </span></span></span></strong><span style="font-size:11pt"><span style="font-family:&quot;PT Serif&quot;,serif"><span style="color:#222222">Men and women exhibit different heart failure (HF) phenotypes and are known to experience distinct outcomes regarding advanced HF. Nevertheless, current guidelines lack sex-specific recommendations. </span></span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:&quot;PT Serif&quot;,serif"><span style="color:#222222">Objective: </span></span></span></strong><span style="font-size:11pt"><span style="font-family:&quot;PT Serif&quot;,serif"><span style="color:#222222">Compare sex-based disparities in patients (pts) with HF with ejection fraction (EF) &lt;50% followed up at a specific HF clinic in a Portuguese regional hospital.</span></span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:&quot;PT Serif&quot;,serif"><span style="color:#222222">Methods: </span></span></span></strong><span style="font-size:11pt"><span style="font-family:&quot;PT Serif&quot;,serif"><span style="color:#222222">Retrospective single-center cohort study of adult pts followed up for &ge;6 months from 2018 to 2022. Pts with end-stage renal disease or Stage D HF (ACC/AHA classification) were excluded. Data regarding clinical characteristics, cardiac procedures, HF characterization based on EF and etiology was obtained. Expanded major adverse cardiac events (MACE) over an 18-month period were defined as all-cause mortality, cardiovascular (CV) mortality, myocardial infarction, coronary revascularization, stroke and HF hospitalization. We compared pts based on their sex &ndash; male pts and female pts. </span></span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:&quot;PT Serif&quot;,serif"><span style="color:#222222">Results: </span></span></span></strong><span style="font-size:11pt"><span style="font-family:&quot;PT Serif&quot;,serif"><span style="color:#222222">A total of 209 pts were included, of which 60 (29%) were female. Female pts were less frequently smokers (13 vs 52%) and alcohol abusers (3 vs 38%) (both p&lt;0.001) and had lower rates of coronary artery disease (17 vs 42%,p&lt;0.001) or previous ischemic stroke (2 vs 15%,p=0.005), but more frequently had overweight (50 vs 32%,p=0.016), depression (23 vs 3%,p&lt;0.001), hypothyroidism (15 vs 6%,p=0.037) and asthma (8 vs 2%,p=0.045). Family history of CV disease was more common in women (17% vs 5%,p=0.008). Regarding procedures, female pts were less submitted to coronary artery bypass graft (2 vs 11%, p=0.023). Regarding HF characterization, the majority of pts had EF &lt;40% (91 vs 94%, p=0.751) and the mean lowest EF was similar (EF 30% vs EF 29%, p=0.210). Ischemic cause was less frequent in females (25 vs 46%, p=0.004). Female pts more frequently experienced improvement in EF throughout follow up, with 35% having recovered EF (EF &gt;50% on latest echocardiography) versus 22% of male pts (p=0.042). Concerning chronic medication, no statistically significant difference was found between groups. Women and men had similar rates of worsening heart failure (17 vs 15%), and no difference was found on all-cause mortality (5 vs 4%) or 18-month MACE (17 vs 15%) (all p&gt;0.05)</span></span></span><span style="font-size:11pt"><span style="font-family:&quot;PT Serif&quot;,serif"><span style="color:#222222">. </span></span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:&quot;PT Serif&quot;,serif"><span style="color:#222222">Conclusion: </span></span></span></strong><span style="font-size:11pt"><span style="font-family:&quot;PT Serif&quot;,serif"><span style="color:#222222">In this HF population, we found differences regarding baseline characteristics and HF characterization, but outcomes, particularly regarding worsening heart failure and MACE, did not significantly differ between sexes.</span></span></span></span></span></span></p>