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Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P ≤ 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P = 0.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P < 0.001) and there were no differences in causes of death. All-cause mortality and all-cause hospitalization increased with greater age in both sexes. Sex was not an independent predictor of 1-year all-cause mortality (restricted to patients with LVEF ≤45%). Mortality risk was significantly lower in patients of younger age, compared to patients aged >75 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF ≤45%.
Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry / Lainscak, M., Milinkovic, I., Polovina, M., Crespo-Leiro, M.G., Lund, L.H., Anker, S.D., Laroche, C., Ferrari, R., Coats, A.J.S., Mcdonagh, T., Filippatos, G., Maggioni, A.P., Piepoli, M.F., Rosano, G.M.C., Ruschitzka, F., Simic, D., Asanin, M., Eicher, J.-C., Yilmaz, M.B., Seferovic, P.M., et al.. - In: EUROPEAN JOURNAL OF HEART FAILURE. - ISSN 1388-9842. - 22:1(2020), pp. 92-102. [10.1002/ejhf.1645]
Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry
Lainscak M.;Milinkovic I.;Polovina M.;Crespo-Leiro M. G.;Lund L. H.;Anker S. D.;Laroche C.;Ferrari R.;Coats A. J. S.;McDonagh T.;Filippatos G.;Maggioni A. P.;Piepoli M. F.;Rosano G. M. C.;Ruschitzka F.;Simic D.;Asanin M.;Eicher J. -C.;Yilmaz M. B.;Seferovic P. M.;Gale C. P.;Chair G. B.;Branko Beleslin R. S.;Andrzej Budaj P. L.;Chioncel R. O.;Nikolaos Dagres D. E.;Nicolas Danchin F. R.;David Erlinge S. E.;Jonathan Emberson G. B.;Michael Glikson I. L.;Alastair Gray G. B.;Meral Kayikcioglu T. R.;Aldo Maggioni I. T.;Klaudia Vivien Nagy H. U.;Aleksandr Nedoshivin R. U.;Anna-Sonia Petronio I. T.;Jolien Roos-Hesselink N. L.;Lars Wallentin S. E.;Uwe Zeymer D. E.;Crespo-Leiro M.;Mebazaa A.;Coats A.;A. Goda A. L.;M. Diez A. R.;A. Fernandez A. R.;F. Fruhwald A. T.;Fazlibegovic E.;P. Gatzov B. G.;A. Kurlianskaya B. Y.;R. Hullin C. H.;T. Christodoulides C. Y.;J. Hradec C. Z.;O. Wendelboe Nielsen D. K.;R. Nedjar D. Z.;T. Uuetoa E. E.;M. Hassanein E. G.;J. F. Delgado Jimenez E. S.;V-P. Harjola F. I.;D. Logeart F. R.;V. Chumburidze G. E.;D. Tousoulis G. R.;D. Milicic H. R.;B. Merkely H. U.;O'Donoghue IE E.;O. Amir I. L.;A. Shotan I. L.;D. Shafie I. R.;M. Metra I. T.;A. Matsumori J. P.;E. Mirrakhimov K. G.;A. Kavoliuniene L. T.;A. Erglis L. V.;Vataman E.;M. Otljanska M. K.;E. Srbinovska Kostovska M. K.;D. Cassar DeMarco M. T.;J. Drozdz P. L.;Fonseca C.;M. Dekleva R. S.;E. Shkolnik R. U.;U. Dahlstrom S. E.;M. Lainscak S. I.;E. Goncalvesova S. K.;A. Temizhan T. R.;V. Estrago U. Y.;G. Bajraktari X. K.;Auer J.;Ablasser K.;Fruhwald F.;Dolze T.;Brandner K.;Gstrein S.;Poelzl G.;Moertl D.;Reiter S.;Podczeck-Schweighofer A.;Muslibegovic A.;Vasilj M.;Cesko M.;Zelenika D.;Palic B.;Pravdic D.;Cuk D.;Vitlianova K.;Katova T.;Velikov T.;Kurteva T.;Gatzov P.;Kamenova D.;Antova M.;Sirakova V.;Krejci J.;Mikolaskova M.;Spinar J.;Krupicka J.;Malek F.;Hegarova M.;Lazarova M.;Monhart Z.;Hassanein M.;Sobhy M.;El Messiry F.;El Shazly A. H.;Elrakshy Y.;Youssef A.;Moneim A. A.;Noamany M.;Reda A.;Dayem T. K. A.;Farag N.;Halawa S. I.;Hamid M. A.;Said K.;Saleh A.;Ebeid H.;Hanna R.;Aziz R.;Louis O.;Enen M. A.;Ibrahim B. S.;Nasr G.;Elbahry A.;Sobhy H.;Ashmawy M.;Gouda M.;Aboleineen W.;Bernard Y.;Luporsi P.;Meneveau N.;Pillot M.;Morel M.;Seronde M. -F.;Schiele F.;Briand F.;Delahaye F.;Damy T.;de Groote P.;Fertin M.;Lamblin N.;Isnard R.;Lefol C.;Thevenin S.;Hagege A.;Jondeau G.;Logeart D.;Le Marcis V.;Ly J. -F.;Coisne D.;Lequeux B.;Le Moal V.;Mascle S.;Lotton P.;Behar N.;Donal E.;Thebault C.;Ridard C.;Reynaud A.;Basquin A.;Bauer F.;Codjia R.;Galinier M.;Tourikis P.;Stavroula M.;Tousoulis D.;Stefanadis C.;Chrysohoou C.;Kotrogiannis I.;Matzaraki V.;Dimitroula T.;Karavidas A.;Tsitsinakis G.;Kapelios C.;Nanas J.;Kampouri H.;Nana E.;Kaldara E.;Eugenidou A.;Vardas P.;Saloustros I.;Patrianakos A.;Tsaknakis T.;Evangelou S.;Nikoloulis N.;Tziourganou H.;Tsaroucha A.;Papadopoulou A.;Douras A.;Polgar L.;Merkely B.;Kosztin A.;Nyolczas N.;Nagy A. C.;Halmosi R.;Elber J.;Alony I.;Shotan A.;Fuhrmann A. V.;Amir O.;Romano S.;Marcon S.;Penco M.;Di Mauro M.;Lemme E.;Carubelli V.;Rovetta R.;Metra M.;Bulgari M.;Quinzani F.;Lombardi C.;Bosi S.;Schiavina G.;Squeri A.;Barbieri A.;Di Tano G.;Pirelli S.;Fucili A.;Passero T.;Musio S.;Di Biase M.;Correale M.;Salvemini G.;Brognoli S.;Zanelli E.;Giordano A.;Agostoni P.;Italiano G.;Salvioni E.;Copelli S.;Modena M. G.;Reggianini L.;Valenti C.;Olaru A.;Bandino S.;Deidda M.;Mercuro G.;Dessalvi C. C.;Marino P. N.;Di Ruocco M. V.;Sartori C.;Piccinino C.;Parrinello G.;Licata G.;Torres D.;Giambanco S.;Busalacchi S.;Arrotti S.;Novo S.;Inciardi R. M.;Pieri P.;Chirco P. R.;Galifi M. A.;Teresi G.;Buccheri D.;Minacapelli A.;Veniani M.;Frisinghelli A.;Priori S. G.;Cattaneo S.;Opasich C.;Gualco A.;Pagliaro M.;Mancone M.;Fedele F.;Cinque A.;Vellini M.;Scarfo I.;Romeo F.;Ferraiuolo F.;Sergi D.;Anselmi M.;Melandri F.;Leci E.;Iori E.;Bovolo V.;Pidello S.;Frea S.;Bergerone S.;Botta M.;Canavosio F. 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W.;Drozdz J.;Huziuk I.;Retwinski A.;Flis P.;Weglarz J.;Bodys A.;Grajek S.;Kaluzna-Oleksy M.;Straburzynska-Migaj E.;Dankowski R.;Szymanowska K.;Grabia J.;Szyszka A.;Nowicka A.;Samcik M.;Wolniewicz L.;Baczynska K.;Komorowska K.;Poprawa I.;Komorowska E.;Sajnaga D.;Zolbach A.;Dudzik-Plocica A.;Abdulkarim A. -F.;Lauko-Rachocka A.;Kaminski L.;Kostka A.;Cichy A.;Ruszkowski P.;Splawski M.;Fitas G.;Szymczyk A.;Serwicka A.;Fiega A.;Zysko D.;Krysiak W.;Szabowski S.;Skorek E.;Pruszczyk P.;Bienias P.;Ciurzynski M.;Welnicki M.;Mamcarz A.;Folga A.;Zielinski T.;Rywik T.;Leszek P.;Sobieszczanska-Malek M.;Piotrowska M.;Kozar-Kaminska K.;Komuda K.;Wisniewska J.;Tarnowska A.;Balsam P.;Marchel M.;Opolski G.;Kaplon-Cieslicka A.;Gil R. 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F.;Ferreira C.;Araujo C.;Ferreira A.;Baptista A.;Radoi M.;Bicescu G.;Vinereanu D.;Sinescu C. -J.;Macarie C.;Popescu R.;Daha I.;Dan G. -A.;Stanescu C.;Dan A.;Craiu E.;Nechita E.;Aursulesei V.;Christodorescu R.;Otasevic P.;Simeunovic D.;Ristic A. D.;Celic V.;Pavlovic-Kleut M.;Lazic J. S.;Stojcevski B.;Pencic B.;Stevanovic A.;Andric A.;Iric-Cupic V.;Jovic M.;Davidovic G.;Milanov S.;Mitic V.;Atanaskovic V.;Antic S.;Pavlovic M.;Stanojevic D.;Stoickov V.;Ilic S.;Ilic M. D.;Petrovic D.;Stojsic S.;Kecojevic S.;Dodic S.;Adic N. C.;Cankovic M.;Stojiljkovic J.;Mihajlovic B.;Radin A.;Radovanovic S.;Krotin M.;Klabnik A.;Goncalvesova E.;Pernicky M.;Murin J.;Kovar F.;Kmec J.;Semjanova H.;Strasek M.;Iskra M. S.;Ravnikar T.;Suligoj N. C.;Komel J.;Fras Z.;Jug B.;Glavic T.;Losic R.;Bombek M.;Krajnc I.;Krunic B.;Horvat S.;Kovac D.;Rajtman D.;Cencic V.;Letonja M.;Winkler R.;Valentincic M.;Melihen-Bartolic C.;Bartolic A.;Vrckovnik M. P.;Kladnik M.;Pusnik C. S.;Marolt A.;Klen J.;Drnovsek B.;Leskovar B.;Anguita M. J. F.;Page J. C. G.;Martinez F. M. S.;Andres J.;Bayes-Genis A.;Mirabet S.;Mendez A.;Garcia-Cosio L.;Roig E.;Leon V.;Gonzalez-Costello J.;Muntane G.;Garay A.;Alcade-Martinez V.;Fernandez S. L.;Rivera-Lopez R.;Puga-Martinez M.;Fernandez-Alvarez M.;Serrano-Martinez J. L.;Grille-Cancela Z.;Marzoa-Rivas R.;Blanco-Canosa P.;Paniagua-Martin M. J.;Barge-Caballero E.;Cerdena I. L.;Baldomero I. F. H.;Padron A. L.;Rosillo S. O.;Gonzalez-Gallarza R. D.;Montanes O. S.;Manjavacas A. M. I.;Conde A. C.;Araujo A.;Soria T.;Garcia-Pavia P.;Gomez-Bueno M.;Cobo-Marcos M.;Alonso-Pulpon L.;Cubero J. S.;Sayago I.;Gonzalez-Segovia A.;Briceno A.;Subias P. E.;Hernandez M. V.;Cano M. J. R.;Sanchez M. A. G.;Jimenez J. F. D.;Garrido-Lestache E. B.;Pinilla J. M. G.;de la Villa B. G.;Sahuquillo A.;Marques R. B.;Calvo F. T.;Perez-Martinez M. T.;Gracia-Rodenas M. R.;Garrido-Bravo I. P.;Pastor-Perez F.;Pascual-Figal D. A.;Molina B. D.;Orus J.;Gonzalo F. E.;Bertomeu V.;Valero R.;Martinez-Abellan R.;Quiles J.;Rodrigez-Ortega J. A.;Mateo I.;ElAmrani A.;Fernandez-Vivancos C.;Valero D. B.;Almenar-Bonet L.;Sanchez-Lazaro I. J.;Marques-Sule E.;Facila-Rubio L.;Perez-Silvestre J.;Garcia-Gonzalez P.;Ridocci-Soriano F.;Garcia-Escriva D.;Pellicer-Cabo A.;de la Fuente Galan L.;Diaz J. L.;Platero A. R.;Arias J. C.;Blasco-Peiro T.;Julve M. S.;Sanchez-Insa E.;Aured-Guallar C.;Portoles-Ocampo A.;Melin M.;Hagglund E.;Stenberg A.;Lindahl I. -M.;Asserlund B.;Olsson L.;Dahlstrom U.;Afzelius M.;Karlstrom P.;Tengvall L.;Wiklund P. -A.;Olsson B.;Kalayci S.;Temizhan A.;Cavusoglu Y.;Gencer E.;Gunes H.
2020
Abstract
Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P ≤ 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P = 0.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P < 0.001) and there were no differences in causes of death. All-cause mortality and all-cause hospitalization increased with greater age in both sexes. Sex was not an independent predictor of 1-year all-cause mortality (restricted to patients with LVEF ≤45%). Mortality risk was significantly lower in patients of younger age, compared to patients aged >75 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF ≤45%.
Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry / Lainscak, M., Milinkovic, I., Polovina, M., Crespo-Leiro, M.G., Lund, L.H., Anker, S.D., Laroche, C., Ferrari, R., Coats, A.J.S., Mcdonagh, T., Filippatos, G., Maggioni, A.P., Piepoli, M.F., Rosano, G.M.C., Ruschitzka, F., Simic, D., Asanin, M., Eicher, J.-C., Yilmaz, M.B., Seferovic, P.M., et al.. - In: EUROPEAN JOURNAL OF HEART FAILURE. - ISSN 1388-9842. - 22:1(2020), pp. 92-102. [10.1002/ejhf.1645]
Lainscak, M.; Milinkovic, I.; Polovina, M.; Crespo-Leiro, M. G.; Lund, L. H.; Anker, S. D.; Laroche, C.; Ferrari, R.; Coats, A. J. S.; Mcdonagh, T.; F...espandi
Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1222974
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