title: Regional differences among female patients with heart failure from the Cardiac Insufficiency BIsoprolol Study in ELDerly (CIBIS-ELD).
abstract: BACKGROUND
  The aim of our study was to examine regional differences in the demographics, etiology, risk factors, comorbidities and treatment of female patients with heart failure (HF) in the Cardiac Insufficiency BIsoprolol Study in ELDerly (CIBIS-ELD) clinical trial.
  
  
  RESULTS
  One hundred and fifty-nine female patients from Germany and 169 from Southeastern (SE) Europe (Serbia, Slovenia and Montenegro) were included in this subanalysis of the CIBIS-ELD trial. Women comprised 54% of the study population in Germany and 29% in SE Europe. German patients were significantly older. The leading cause of HF was arterial hypertension in German patients, 71.7% of whom had a preserved ejection fraction. The leading etiology in SE Europe was the coronary artery disease; 67.6% of these patients had a reduced left ventricular ejection fraction (34.64 ± 7.75%). No significant differences were found in the prevalence of traditional cardiovascular risk factors between the two regions (hypertension, diabetes, hypercholesterolemia, smoking and family history of myocardial infarction). Depression, chronic obstructive pulmonary disease and malignancies were the comorbidities that were noted more frequently in the German patients, while the patients from SE Europe had a lower glomerular filtration rate. Compared with the German HF patients, the females in SE Europe received significantly more angiotensin converting enzyme inhibitors, loop diuretics and less frequently angiotensin receptor blockers and mineralocorticoid receptor antagonists.
  
  
  CONCLUSIONS
  Significant regional differences were noted in the etiology, comorbidities and treatment of female patients with HF despite similar risk factors. Such differences should be considered in the design and implementation of future clinical trials, especially as women remain underrepresented in large trial populations.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Apostolovic
authors.affiliation: Clinic for cardiovascular diseases, Clinical Center Nis, Serbia. draganastanojevic1@gmail.com.
authors.forename: Dragana
authors.initials: D
authors.lastname: Stanojevic
authors.forename: Mitja
authors.initials: M
authors.lastname: Lainscak
authors.forename: Goetz
authors.initials: G
authors.lastname: Gelbrich
authors.forename: Ruzica
authors.initials: R
authors.lastname: Jankovic-Tomasevic
authors.forename: Milan
authors.initials: M
authors.lastname: Pavlovic
authors.forename: Danijela
authors.initials: D
authors.lastname: Djordjevic-Radojkovic
authors.forename: Sonja
authors.initials: S
authors.lastname: Salinger-Martinovic
authors.forename: Biljana
authors.initials: B
authors.lastname: Putnikovic
authors.forename: Slavica
authors.initials: S
authors.lastname: Radovanovic
authors.forename: Finn
authors.initials: F
authors.lastname: Waagstein
authors.forename: Miloje
authors.initials: M
authors.lastname: Tomasevic
authors.forename: Elvis
authors.initials: E
authors.lastname: Tahirovic
authors.forename: Simone
authors.initials: S
authors.lastname: Inkrot
authors.forename: Lindy
authors.initials: L
authors.lastname: Musial-Bright
authors.forename: Hans-Dirk
authors.initials: HD
authors.lastname: Düngen
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000008:administration & dosage; D058671:Adrenergic beta-1 Receptor Antagonists / Q000008:administration & dosage; D000368:Aged; D017298:Bisoprolol / Q000008:administration & dosage*; D002227:Carbazoles / Q000008:administration & dosage*; D000077261:Carvedilol; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005060:Europe / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D008297:Male; D011412:Propanolamines / Q000008:administration & dosage*; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D058671:Adrenergic beta-1 Receptor Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D017298:Bisoprolol