title: Gender-related differences in patients with acute heart failure: management and predictors of in-hospital mortality.
abstract: OBJECTIVE
  Gender-related differences in clinical phenotype, in-hospital management and prognosis of acute heart failure (AHF) patients have been previously reported in European and US registries. The ALARM-HF survey is the first to include a cohort of 4953 patients hospitalized for AHF in 666 hospitals in 6 European countries, Mexico and Australia.
  
  
  RESULTS
  Women accounted for 37% of the study population, were older and had higher rates of de novo heart failure (45% vs 36%, p<0.001) than men. An acute coronary syndrome (ACS) was the predominant precipitating factor in both genders, but to a lesser extent in females (30% vs 42%, p<0.001). Between genders comparison showed higher incidence of atrial fibrillation, valvular heart disease, diabetes, obesity, anemia and depression in women (p<0.05). Similarly, women had higher left ventricular ejection fraction (LVEF) on admission (42 ± 15% vs 36 ± 13%, p<0.001) and systolic blood pressure (135 ± 40 mm Hg vs 131 ± 39 mm Hg, p=0.001) than men. On the other hand, men had more often coronary artery disease, renal failure and chronic obstructive pulmonary disease (p<0.05). Importantly, in-hospital mortality was similar in both genders (11.1% in females vs 10.5% in males, p=0.475), and its common predictors were: systolic blood pressure at admission, creatinine>1.5mg/dL and diabetes. Furthermore, recent ACS, valvular heart disease and dementia contributed to prognosis in women, while LVEF, hypertension and anemia were independent predictors in men.
  
  
  CONCLUSIONS
  Among patients with AHF, there are significant differences in co-morbidities, precipitating factors and predictors of in-hospital mortality between genders. Nevertheless, in-hospital mortality remains similar between genders.
authors.affiliation: Second Cardiology Department, Attikon University Hospital, Athens, Greece. jparissis@yahoo.com
authors.forename: John T
authors.initials: JT
authors.lastname: Parissis
authors.forename: Lilian
authors.initials: L
authors.lastname: Mantziari
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kaldoglou
authors.forename: Ignatios
authors.initials: I
authors.lastname: Ikonomidis
authors.forename: Maria
authors.initials: M
authors.lastname: Nikolaou
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mebazaa
authors.forename: Johann
authors.initials: J
authors.lastname: Altenberger
authors.forename: Juan
authors.initials: J
authors.lastname: Delgado
authors.forename: Fabio
authors.initials: F
authors.lastname: Vilas-Boas
authors.forename: Ioannis
authors.initials: I
authors.lastname: Paraskevaidis
authors.forename: Maria
authors.initials: M
authors.lastname: Anastasiou-Nana
authors.forename: Ferenc
authors.initials: F
authors.lastname: Follath
mesh_terms: D000208:Acute Disease; D000368:Aged; D019468:Disease Management; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D012727:Sex Characteristics