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Sex Differences in Characteristics and Management of Patients with Acute Heart Failure

Received: 21 May 2017    Accepted: 1 June 2017    Published: 24 July 2017
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Abstract

Burden of heart failure (HF) among females is growing. However, whether characteristics and management of acute HF differ according to sex is unknown. Therefore, the aim of the present study was to provide information about this concern from a real life perspective. Data from the Scompenso Cardiaco in Medicina Interna in Toscana (SMIT) Study, an observational, retrospective, multicenter 30-day cross-sectional study performed in thirty-two Internal Medicine wards of Tuscany, Italy, were analyzed. The present sub-analysis focused on the difference between female and male patients. Overall, seven hundred and seventy patients were enrolled in the SMIT Study. Of these, four hundred and twenty-nine (55.7%) were females. Females were significantly older than males. Seventy-two women (16.7%) and forty-eight men (14%) presented a new onset HF, whereas the majority of patients presented at least one previous hospital admission for HF in their history. No difference in length of hospital stay and mortality was found between sexes. Hypertensive (26.8% vs 19.8%, p = 0.02) and valvular (13.6% vs 8.6%, p = 0.03) were the more prevalent etiologies of HF in females, while ischemic heart disease was in males (25.8% vs 18.2%, p = 0.01). HF with a preserved left ventricle ejection fraction (LVEF) was significantly more prevalent in females compared to males (51.3% vs 32.6%, p = 0.0001). Chronic obstructive pulmonary disease (COPD), peripheral artery diseases (PAD) and severe anemia were more frequent in males, while cognitive impairment was in females. Mean creatinine clearance at hospital admission was lower in females than in males (44.4 ± 22.2 vs 49.4 ± 26.3 ml/min, p < 0.05). Females received more frequently non invasive ventilation compared to males (15.1% vs 9.1%, p = 0.011). No difference between sexes was registered in the use of diuretics, angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, beta blockers and digoxin, whereas the use of anti-aldosterone agents, ivabradine and statins were more frequently used in males. No difference between sexes was found in the median number of drugs prescribed at hospital discharge [8 (interquartile range, IQR, 6-11) vs 9 (IQR 7-11)]. Eighty-two percent of females and seventy-nine percent of males were discharged at home (p = ns). Fifty-six percent of females compared with forty percent of males were dependent in activities of daily living at hospital discharge (p = 0.0001). The present study demonstrates that demographic characteristics, etiology, co-morbidity and echocardiographic pattern of HF differ according to sex. Further prospective study are warranted.

Published in Cardiology and Cardiovascular Research (Volume 1, Issue 3)
DOI 10.11648/j.ccr.20170103.13
Page(s) 84-90
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Heart Failure, Gender, Management, Prognosis, Drugs

References
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Cite This Article
  • APA Style

    Paolo Biagi, Valerio Verdiani, Grazia Panigada, Vieri Vannucchi, Luca Masotti, et al. (2017). Sex Differences in Characteristics and Management of Patients with Acute Heart Failure. Cardiology and Cardiovascular Research, 1(3), 84-90. https://doi.org/10.11648/j.ccr.20170103.13

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    ACS Style

    Paolo Biagi; Valerio Verdiani; Grazia Panigada; Vieri Vannucchi; Luca Masotti, et al. Sex Differences in Characteristics and Management of Patients with Acute Heart Failure. Cardiol. Cardiovasc. Res. 2017, 1(3), 84-90. doi: 10.11648/j.ccr.20170103.13

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    AMA Style

    Paolo Biagi, Valerio Verdiani, Grazia Panigada, Vieri Vannucchi, Luca Masotti, et al. Sex Differences in Characteristics and Management of Patients with Acute Heart Failure. Cardiol Cardiovasc Res. 2017;1(3):84-90. doi: 10.11648/j.ccr.20170103.13

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  • @article{10.11648/j.ccr.20170103.13,
      author = {Paolo Biagi and Valerio Verdiani and Grazia Panigada and Vieri Vannucchi and Luca Masotti and Alberto Fortini},
      title = {Sex Differences in Characteristics and Management of Patients with Acute Heart Failure},
      journal = {Cardiology and Cardiovascular Research},
      volume = {1},
      number = {3},
      pages = {84-90},
      doi = {10.11648/j.ccr.20170103.13},
      url = {https://doi.org/10.11648/j.ccr.20170103.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20170103.13},
      abstract = {Burden of heart failure (HF) among females is growing. However, whether characteristics and management of acute HF differ according to sex is unknown. Therefore, the aim of the present study was to provide information about this concern from a real life perspective. Data from the Scompenso Cardiaco in Medicina Interna in Toscana (SMIT) Study, an observational, retrospective, multicenter 30-day cross-sectional study performed in thirty-two Internal Medicine wards of Tuscany, Italy, were analyzed. The present sub-analysis focused on the difference between female and male patients. Overall, seven hundred and seventy patients were enrolled in the SMIT Study. Of these, four hundred and twenty-nine (55.7%) were females. Females were significantly older than males. Seventy-two women (16.7%) and forty-eight men (14%) presented a new onset HF, whereas the majority of patients presented at least one previous hospital admission for HF in their history. No difference in length of hospital stay and mortality was found between sexes. Hypertensive (26.8% vs 19.8%, p = 0.02) and valvular (13.6% vs 8.6%, p = 0.03) were the more prevalent etiologies of HF in females, while ischemic heart disease was in males (25.8% vs 18.2%, p = 0.01). HF with a preserved left ventricle ejection fraction (LVEF) was significantly more prevalent in females compared to males (51.3% vs 32.6%, p = 0.0001). Chronic obstructive pulmonary disease (COPD), peripheral artery diseases (PAD) and severe anemia were more frequent in males, while cognitive impairment was in females. Mean creatinine clearance at hospital admission was lower in females than in males (44.4 ± 22.2 vs 49.4 ± 26.3 ml/min, p < 0.05). Females received more frequently non invasive ventilation compared to males (15.1% vs 9.1%, p = 0.011). No difference between sexes was registered in the use of diuretics, angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, beta blockers and digoxin, whereas the use of anti-aldosterone agents, ivabradine and statins were more frequently used in males. No difference between sexes was found in the median number of drugs prescribed at hospital discharge [8 (interquartile range, IQR, 6-11) vs 9 (IQR 7-11)]. Eighty-two percent of females and seventy-nine percent of males were discharged at home (p = ns). Fifty-six percent of females compared with forty percent of males were dependent in activities of daily living at hospital discharge (p = 0.0001). The present study demonstrates that demographic characteristics, etiology, co-morbidity and echocardiographic pattern of HF differ according to sex. Further prospective study are warranted.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - Sex Differences in Characteristics and Management of Patients with Acute Heart Failure
    AU  - Paolo Biagi
    AU  - Valerio Verdiani
    AU  - Grazia Panigada
    AU  - Vieri Vannucchi
    AU  - Luca Masotti
    AU  - Alberto Fortini
    Y1  - 2017/07/24
    PY  - 2017
    N1  - https://doi.org/10.11648/j.ccr.20170103.13
    DO  - 10.11648/j.ccr.20170103.13
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
    SP  - 84
    EP  - 90
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20170103.13
    AB  - Burden of heart failure (HF) among females is growing. However, whether characteristics and management of acute HF differ according to sex is unknown. Therefore, the aim of the present study was to provide information about this concern from a real life perspective. Data from the Scompenso Cardiaco in Medicina Interna in Toscana (SMIT) Study, an observational, retrospective, multicenter 30-day cross-sectional study performed in thirty-two Internal Medicine wards of Tuscany, Italy, were analyzed. The present sub-analysis focused on the difference between female and male patients. Overall, seven hundred and seventy patients were enrolled in the SMIT Study. Of these, four hundred and twenty-nine (55.7%) were females. Females were significantly older than males. Seventy-two women (16.7%) and forty-eight men (14%) presented a new onset HF, whereas the majority of patients presented at least one previous hospital admission for HF in their history. No difference in length of hospital stay and mortality was found between sexes. Hypertensive (26.8% vs 19.8%, p = 0.02) and valvular (13.6% vs 8.6%, p = 0.03) were the more prevalent etiologies of HF in females, while ischemic heart disease was in males (25.8% vs 18.2%, p = 0.01). HF with a preserved left ventricle ejection fraction (LVEF) was significantly more prevalent in females compared to males (51.3% vs 32.6%, p = 0.0001). Chronic obstructive pulmonary disease (COPD), peripheral artery diseases (PAD) and severe anemia were more frequent in males, while cognitive impairment was in females. Mean creatinine clearance at hospital admission was lower in females than in males (44.4 ± 22.2 vs 49.4 ± 26.3 ml/min, p < 0.05). Females received more frequently non invasive ventilation compared to males (15.1% vs 9.1%, p = 0.011). No difference between sexes was registered in the use of diuretics, angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, beta blockers and digoxin, whereas the use of anti-aldosterone agents, ivabradine and statins were more frequently used in males. No difference between sexes was found in the median number of drugs prescribed at hospital discharge [8 (interquartile range, IQR, 6-11) vs 9 (IQR 7-11)]. Eighty-two percent of females and seventy-nine percent of males were discharged at home (p = ns). Fifty-six percent of females compared with forty percent of males were dependent in activities of daily living at hospital discharge (p = 0.0001). The present study demonstrates that demographic characteristics, etiology, co-morbidity and echocardiographic pattern of HF differ according to sex. Further prospective study are warranted.
    VL  - 1
    IS  - 3
    ER  - 

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Author Information
  • Department of Internal Medicine, Montepulciano Hospital, Siena, Italy

  • Department of Internal Medicine, Misericordia Hospital, Grosseto, Italy

  • Department of Internal Medicine, SS Damiano and Cosma Hospital, Pescia, Italy

  • Department of Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy

  • Department of Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy

  • Department of Internal Medicine, San Giovanni di Dio Hospital, Florence, Italy

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