Background: Current data on the influence of gender on the prognosis of heart failure (HF) are conflicting, possibly due to usage of different endpoints and a heterogeneous heart failure population in prior studies. We sought to evaluate the effect of gender on the risk of early and late mortality outcomes following hospitalization for acute heart failure (HF).
Methods and Results: The prospective cohort study population comprised of 2,212 hospitalized patients with acute HF enrolled in a multicenter national survey in Israel. Cox proportional-hazards regression modeling was used to evaluate the effect of gender on the risk of early (≤6 months) and late (>6 months through 4-years) mortality following the index-hospitalization. Among study patients, 998 (45%) were women. Women with HF displayed significantly different clinical characteristics compared with men, including older age, higher frequency of HF with preserved ejection fraction and hypertensive heart disease, and lower percentage of coronary artery disease (all P values <0.001). The fully-adjusted multivariable analyses for mortality outcomes showed that women tended toward an increased risk for early, ≤6 month, mortality (hazard ratio [HR], 1.16; 95% confidence interval [CI], 0.96-1.41; P = 0.13), whereas men had significantly increased risk for late, >6 months, mortality (HR, 1.25; 95% CI, 1.09-1.43, P = 0.001).
Conclusions: There are important differences in the clinical characteristics and the short and long-term outcomes between men and women hospitalized with acute HF after adjusting for multiple confounding variables.
