Relation between gender, etiology and survival in patients with symptomatic heart failure.
OBJECTIVE
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.
Adams
K F
KF
Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill 27599-7075, USA.
Dunlap
S H
SH
Sueta
C A
CA
Clarke
S W
SW
Patterson
J H
JH
Blauwet
M B
MB
Jensen
L R
LR
Tomasko
L
L
Koch
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D013318:Stroke Volume; D015996:Survival Rate