Sex-related differences among young adults with heart failure in Sweden. (1st September 2022)

• Record Type: Journal Article
• Authors: Basic, C.; Rosengren, A.; Dahlström, U.; Edner, M.; Fu, M.; Zverkova-Sandström, T.; Schaufelberger, M.
• Is Part Of: International journal of cardiology. Volume 362(2022)
• Page Start: 97
• Page End: 103
• Publication Date: 2022-09-01
• Subjects: Heart failure -- Young adults -- Sex differences -- Comorbidity -- Mortality -- Survival; ACEI angiotensin-converting enzyme inhibitors -- ARB angiotensin receptor blockers -- DCM dilated cardiomyopathy -- EF ejection fraction -- HCM hypertrophic cardiomyopathy -- HF heart failure -- HOCM hypertrophic obstructive cardiomyopathy -- ICD International Classification of Disease -- IHD ischemic heart disease -- MRA mineralocorticoid receptor antagonists -- NPR National Patient Register -- NYHA New York Heart Association class -- PAH Pulmonary arterial hypertension -- SwedeHF Swedish Heart Failure Register; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2022.04.073
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Differences between the sexes among the non-elderly with heart failure (HF) have been insufficiently evaluated. This study aims to investigate sex-related differences in early-onset HF. Methods: Patients aged 18 to 54 years who were registered from 2003 to 2014 in the Swedish Heart Failure Register were included. Each patient was matched with two controls from the Swedish Total Population Register. Data on comorbidities and outcomes were obtained through the National Patient Register and Cause of Death Register. Results: We identified 3752 patients and 7425 controls. Of the patients, 971 (25.9%) were women and 2781 (74.1%) were men with a mean (standard deviation) age of 44.9 (8.4) and 46.4 (7.3) years, respectively. Men had more hypertension and ischemic heart disease, whereas women had more congenital heart disease and obesity. During the median follow-up of 4.87 years, 26.5 and 24.7 per 1000 person-years male and female patients died, compared with 3.61 and 2.01 per 1000 person-years male and female controls, respectively. The adjusted hazard ratios for all-cause mortality, compared with controls, were 4.77 (3.78–6.01) in men and 7.84 (4.85–12.7) in women (p for sex difference = 0.11). When HF was diagnosed at 30, 35, 40, and 45 years, women and men lost up to 24.6 and 24.2, 24.4 and 20.9, 20.5 and 18.3, and 20.7 and 16.5 years of life, respectively. Conclusion: Long-term mortality was similar between the sexes. Women lost more years of life than men. Highlights: Women and men with HF <55 years had different co-morbidities that were important determinants of prognosis Mortality risk relative to controls was almost twice as high in women than in men although the difference was not significant Women also lost more life-years than men with heart failure <55 years