The 'real' woman with heart failure. Impact of sex on current in-hospital management of heart failure by cardiologists and internists.
OBJECTIVE
To identify differences between sexes in the clinical profile, use of resources, management and outcome in a large population of 'real world' patients with heart failure (HF).


METHODS
A prospective cross-sectional survey was conducted on 2127 consecutive patients (47% women) admitted with HF to 167 cardiology and 250 internal medicine departments between February 14 and 25, 2000.


RESULTS
Women were older, had a higher prevalence of atrial fibrillation, and more frequently a hypertensive or valvular aetiology. Females were admitted more frequently in Medical than in Cardiology Departments. The rate of invasive and non-invasive procedures was lower in women than in men, slightly higher if managed by cardiologists. Women were less frequently prescribed ACE-inhibitors, amiodarone, and spironolactone, and more frequently prescribed digoxin. In-hospital mortality was similar, without difference between health-care providers. A 6-month follow-up was performed in 56.4% of the cases in both setting, but less frequently in women. Event rates were similar with nearly half of patients re-hospitalised at least once.


CONCLUSIONS
The 'real' HF woman has generally a more severe disease; she is an old lady who is more frequently hospitalised in a medical unit, receives few diagnostic, and cardiovascular procedures and pharmacological therapy, has a relatively low probability of dying in hospital, but a high likelihood of requiring readmission.
Opasich
C
C
Department of Cardiology, Salvatore Maugeri Foundation, Pavia, Italy.
De Feo
S
S
Ambrosio
G A
GA
Bellis
P
P
Di Lenarda
A
A
Di Tano
G
G
Fico
D
D
Gonzini
L
L
Lavecchia
R
R
Tomasi
C
C
Maggioni
Aldo P
AP
D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D010359:Patient Readmission; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011379:Prognosis; D012737:Sex Factors; D013148:Spironolactone / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use
D000806:Angiotensin-Converting Enzyme Inhibitors; D014665:Vasodilator Agents; D013148:Spironolactone; D000638:Amiodarone