Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry
Articolo
Data di Pubblicazione:
2019
Abstract:
Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P ≤ 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P = 0.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P < 0.001) and there were no differences in causes of death. All-cause mortality and all-cause hospitalization increased with greater age in both sexes. Sex was not an independent predictor of 1-year all-cause mortality (restricted to patients with LVEF ≤45%). Mortality risk was significantly lower in patients of younger age, compared to patients aged >75 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF ≤45%.
Tipologia CRIS:
1.1 Articolo in rivista
Keywords:
Age; Hospitalization; Mortality; Registry; Sex
Elenco autori:
Lainscak, M.; Milinkovic, I.; Polovina, M.; Crespo-Leiro, M. G.; Lund, L. H.; Anker, S. D.; Laroche, C.; Ferrari, R.; Coats, A. J. S.; Mcdonagh, T.; Filippatos, G.; Maggioni, A. P.; Piepoli, M. F.; Rosano, G. M. C.; Ruschitzka, F.; Simic, D.; Asanin, M.; Eicher, J. -C.; Yilmaz, M. B.; Seferovic, P. M.; Gale, C. P.; Chair, G. B.; Branko Beleslin, R. S.; Andrzej Budaj, P. L.; Ovidiu Chioncel, R. O.; Nikolaos Dagres, D. E.; Nicolas Danchin, F. R.; David Erlinge, S. E.; Jonathan Emberson, G. B.; Michael Glikson, I. L.; Alastair Gray, G. B.; Meral Kayikcioglu, T. R.; Aldo Maggioni, I. T.; Klaudia Vivien Nagy, H. U.; Aleksandr Nedoshivin, R. U.; Anna-Sonia Petronio, I. T.; Jolien Roos-Hesselink, N. L.; Lars Wallentin, S. E.; Uwe Zeymer, D. E.; Crespo-Leiro, M.; Anker, S.; Mebazaa, A.; Coats, A.; Filippatos, G.; Ferrari, R.; Maggioni, A. P.; Piepoli, M. F.; A. Goda A., L.; M. Diez A., R.; A. Fernandez A., R.; F. Fruhwald A., T.; Fazlibegovic, E.; P. Gatzov B., G.; A. Kurlianskaya B., Y.; R. Hullin C., H.; T. Christodoulides C., Y.; J. Hradec C., Z.; O. Wendelboe Nielsen D., K.; R. Nedjar D., Z.; T. Uuetoa E., E.; M. Hassanein E., G.; J. F. Delgado Jimenez E., S.; V-, P. Harjola F. I.; D. Logeart F., R.; V. Chumburidze G., E.; D. Tousoulis G., R.; D. Milicic H., R.; B. Merkely H., U.; O'Donoghue IE, E.; O. Amir I., L.; A. Shotan I., L.; D. Shafie I., R.; M. Metra I., T.; A. Matsumori J., P.; E. Mirrakhimov K., G.; A. Kavoliuniene L., T.; A. Erglis L., V.; Vataman, E.; M. Otljanska M., K.; E. Srbinovska Kostovska M., K.; D. Cassar DeMarco M., T.; J. Drozdz P., L.; Fonseca, C.; O. Chioncel R., O.; M. Dekleva R., S.; E. Shkolnik R., U.; U. Dahlstrom S., E.; M. Lainscak S., I.; E. Goncalvesova S., K.; A. Temizhan T., R.; V. Estrago U., Y.; G. Bajraktari X., K.; Auer, J.; Ablasser, K.; Fruhwald, F.; Dolze, T.; Brandner, K.; Gstrein, S.; Poelzl, G.; Moertl, D.; Reiter, S.; Podczeck-Schweighofer, A.; Muslibegovic, A.; Vasilj, M.; Fazlibegovic, E.; Cesko, M.; Zelenika, D.; Palic, B.; Pravdic, D.; Cuk, D.; Vitlianova, K.; Katova, T.; Velikov, T.; Kurteva, T.; Gatzov, P.; Kamenova, D.; Antova, M.; Sirakova, V.; Krejci, J.; Mikolaskova, M.; Spinar, J.; Krupicka, J.; Malek, F.; Hegarova, M.; Lazarova, M.; Monhart, Z.; Hassanein, M.; Sobhy, M.; El Messiry, F.; El Shazly, A. H.; Elrakshy, Y.; Youssef, A.; Moneim, A. A.; Noamany, M.; Reda, A.; Dayem, T. K. A.; Farag, N.; Halawa, S. I.; Hamid, M. A.; Said, K.; Saleh, A.; Ebeid, H.; Hanna, R.; Aziz, R.; Louis, O.; Enen, M. A.; Ibrahim, B. S.; Nasr, G.; Elbahry, A.; Sobhy, H.; Ashmawy, M.; Gouda, M.; Aboleineen, W.; Bernard, Y.; Luporsi, P.; Meneveau, N.; Pillot, M.; Morel, M.; Seronde, M. -F.; Schiele, F.; Briand, F.; Delahaye, F.; Damy, T.; Eicher, J. -C.; de Groote, P.; Fertin, M.; Lamblin, N.; Isnard, R.; Lefol, C.; Thevenin, S.; Hagege, A.; Jondeau, G.; Logeart, D.; Le Marcis, V.; Ly, J. -F.; Coisne, D.; Lequeux, B.; Le Moal, V.; Mascle, S.; Lotton, P.; Behar, N.; Donal, E.; Thebault, C.; Ridard, C.; Reynaud, A.; Basquin, A.; Bauer, F.; Codjia, R.; Galinier, M.; Tourikis, P.; Stavroula, M.; Tousoulis, D.; Stefanadis, C.; Chrysohoou, C.; Kotrogiannis, I.; Matzaraki, V.; Dimitroula, T.; Karavidas, A.; Tsitsinakis, G.; Kapelios, C.; Nanas, J.; Kampouri, H.; Nana, E.; Kaldara, E.; Eugenidou, A.; Vardas, P.; Saloustros, I.; Patrianakos, A.; Tsaknakis, T.; Evangelou, S.; Nikoloulis, N.; Tziourganou, H.; Tsaroucha, A.; Papadopoulou, A.; Douras, A.; Polgar, L.; Merkely, B.; Kosztin, A.; Nyolczas, N.; Nagy, A. C.; Halmosi, R.; Elber, J.; Alony, I.; Shotan, A.; Fuhrmann, A. V.; Amir, O.; Romano, S.; Marcon, S.; Penco, M.; Di Mauro, M.; Lemme, E.; Carubelli, V.; Rovetta, R.; Metra, M.; Bulgari, M.; Quinzani, F.; Lombardi, C.; Bosi, S.; Schiavina, G.; Squeri, A.; Barbieri, A.; Di Tano, G.; Pirelli, S.; Ferrari, R.; Fucili, A.; Passero, T.; Musio, S.; Di Biase, M.; Correale, M.; Salvemini, G.; Brognoli, S.; Zanelli, E.; Giordano, A.; Agostoni, P.; Italiano, G.; Salvioni, E.; Copelli, S.; Modena, M. G.; Reggian
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