Influence of sex and pregnancy on survival in patients admitted with heart failure: Data from a prospective multicenter registry

Manuel Martínez-Sellés, Pablo Díez-Villanueva, Jesús Álvarez-Gracía, Andreu Ferrero-Gregori, Miquel Vives-Borrás, Fernando Worner, Alfredo Bardají, Juan F. Delgado, Rafael Vázquez, José R. González-Juanatey, Francisco Fernández-Aviles, Juan Cinca

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Abstract

© 2018 Wiley Periodicals, Inc. Background: Female sex is an independent predictor of better survival in patients with heart failure (HF), but the mechanism of this association is unknown. On the other hand, pregnancies have a strong influence on the cardiovascular system. Hypothesis: Sex and previous gestations might have a prognostic impact on 1-year mortality in patients admitted with HF. Methods: We conducted an observational, prospective, consecutive, multicenter registry of 1831 patients (756 females [41.2%]) admitted with HF. Results: Females had a more advanced age (75.2 ±11.4 vs 70.4 ±12.2 years), less ischemic heart disease (167 [25.3%] vs 446 [47.3%]), and higher left ventricular ejection fraction (52.0% ±16.6% vs 41.1% ±17.0%) than did men (all P values <0.001). During 1-year follow-up, 373 (20.4%) patients died (151 females and 222 males). Female sex was an independent predictor for survival (hazard ratio: 0.79, 95% confidence interval: 0.64–0.98, P = 0.03). In 504 women (65.9%), the exact number of previous pregnancies could be determined; 62 women (12.3%) had no previous pregnancies, 288 (57.1%) women had 1 or 2 pregnancies, and 154 women (30.6%) had ≥3 pregnancies. We found an association between the number of previous gestations and better survival (hazard ratio: 0.878, 95% confidence interval: 0.773–0.997, P = 0.045). Conclusions: In patients admitted with HF, female sex and the number of previous pregnancies are independently associated with better 1-year survival.
Original languageEnglish
Pages (from-to)924-930
JournalClinical Cardiology
Volume41
Issue number7
DOIs
Publication statusPublished - 1 Jul 2018

Keywords

  • Heart Failure
  • Pregnancy
  • Prognosis
  • Sex

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    Martínez-Sellés, M., Díez-Villanueva, P., Álvarez-Gracía, J., Ferrero-Gregori, A., Vives-Borrás, M., Worner, F., Bardají, A., Delgado, J. F., Vázquez, R., González-Juanatey, J. R., Fernández-Aviles, F., & Cinca, J. (2018). Influence of sex and pregnancy on survival in patients admitted with heart failure: Data from a prospective multicenter registry. Clinical Cardiology, 41(7), 924-930. https://doi.org/10.1002/clc.22979