Relation Between Gender, Etiology and Survival in Patients With Symptomatic Heart Failure
Author + information
- Kirkwood F. Adams Jr., MD⁎,
- Stephanie H. Dunlap, DO,
- Carla A. Sueta, MD, PhD,
- Susan W. Clarke, RN, BSN,
- James Herbert Patterson, PharmD,
- Mary Beth Blauwet, DRPH,
- Lynda R. Jensen, MT,
- Lisa Tomasko, MS and
- Gary Koch, PhD
- ↵⁎Address for correspondence: Dr. Kirkwood F. Adams, Jr., Division of Cardiology, University of North Carolina at Chapel Hill, CB 7075, Burnett-Womack Building, Chapel Hill, North Carolina 27599–7075.
Abstract
Objectives This study investigated the relation between gender, etiology and survival in patients with symptomatic heart failure.
Background Previous work provides conflicting results concerning the relation between gender, clinical characteristics and survival in patients with heart failure.
Methods We examined the relation of these factors in 557 patients (380 men, 177 women) who had symptomatic heart failure, predominantly nonischemic in origin (68%) and typically associated with severe left ventricular dysfunction.
Results Follow-up data were available in 99% of patients (mean follow-up period 2.4 years, range 1 day to 10 years) after study entry, and 201 patients reached the primary study end point of all-cause mortality. By life-table analysis, women were significantly less likely to reach this primary end point than men (p <0.001). A significant association was found between female gender and better survival (p < 0.001), which depended on the primary etiology of heart failure (p = 0.008 for the gender-etiology interaction) but not on baseline ventricular function. Women survived longer than men when heart failure was due to nonischemic causes (men vs. women: relative risk [RR] 2.36,95% confidence interval [CI] 1.59 to 3.51, p < 0.001). In contrast, outcome appeared similar when heart failure was due to ischemic heart disease (men vs. women: RR 0.85, 95% CI 0.45 to 1.61, p = 0.651).
Conclusions Women with heart failure due to nonischemic causes had significantly better survival than men with or without coronary disease as their primary cause of heart failure.
Footnotes
This study was supported in part by PHS Research Grant MO1 RR00046 from the General Clinical Research Centers branch of the Division of Research Resources, National Institutes of Health, Bethesda, Maryland.
- Received May 28, 1996.
- Revision received August 8, 1996.
- Accepted August 13, 1996.
- American College of Cardiology
