Female sex and survival in patients hospitalized with acute heart failure and renal dysfunction - Schukraft, S.; Müller, M.; Abdurashidova, T.; Soborun, N.; Tzimas, G.; Pitta-Gros, B.; Antiochos, P.; Lu, H.; Beǐshenkulov, M.; Kirsch, M.; Golshayan, D.; Monney, P.; et al. (International Journal of Cardiology, 2025)
Background: Kidney dysfunction increases the risk of outcomes in patients hospitalized for acute heart failure (AHF). Female sex is associated with better outcomes in kidney dysfunction. The effect of female sex on outcomes in AHF patients with kidney dysfunction remains unclear. Methods and results: This study included Western European and central Asian AHF patients with kidney dysfunction defined as an estimated glomerular filtration rate (eGFR) <90 ml/min. Primary endpoint was 1-year all-cause mortality (ACM), the secondary endpoint was a composite of first HF-related rehospitalization or ACM at 1 year. Overall, 1470 patients were included (46.2 % women, mean age 75.9 ± 12.2 years). Left ventricular ejection fraction was reduced in 40.3 % (n = 593), mildly reduced in 18.9 % (n = 278), and preserved in 40.7 % (n = 599) of study patients. The prevalence of female vs. male sex differed between HF subgroups (HFrEF: 28.3 vs. 50.7 %, HFmrEF: 18.9 vs. 19.0 %; HFpEF: 52.9 vs. 30.3 %, respectively; overall p < 0.001). In multivariable logistic regression analysis adjusted on age among other variables, female sex was associated with a significantly lower risk of 1-year ACM (odds ratio: 0.61, 95 % CI:0.47–0.79, p < 0.001) in all patients as well as in eGFR subgroups (<45 and ≥ 45 ml/min; p = 0.009 and p = 0.030, respectively). No significant association was found between sex and the secondary endpoint (odds ratio 0.83, 95 % CI: 0.66–1.04, p = 0.11). Conclusion: In this real-world cohort of HF patients prospectively enrolled across two different countries, the risk of 1-year ACM was lower among women with AHF and kidney dysfunction © 2024
Keywords: journalArticle; Acute heart failure; Aged, 80 and over; Article; Cardiovascular care; Cohort Studies; Follow-Up Studies; Glomerular Filtration Rate; Humans; Kidney dysfunction; Prospective Studies; Renal Insufficiency; Sex; Sex Factors; acute disease; aged; all cause mortality; area under the curve; atrial fibrillation; body mass; bradycardia; cardiovascular mortality; chronic obstructive lung disease; clinical trial; cohort analysis; congenital heart disease; controlled study; coronary artery bypass graft; creatinine; diabetes mellitus; diagnosis; diagnostic test accuracy study; diastolic blood pressure; estimated glomerular filtration rate; female; follow up; glomerulus filtration rate; heart failure; heart failure with reduced ejection fraction; heart left ventricle ejection fraction; heart muscle ischemia; hospitalization; human; kidney failure; kidney function; lung embolism; major clinical study; male; middle aged; mortality; multicenter study; observational study; outcome assessment; pathophysiology; percutaneous coronary intervention; physiology; prevalence; prospective study; receiver operating characteristic; retrospective study