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首页> 外文期刊>Circulation. Heart failure >Sex differences in clinical characteristics and outcomes in elderly patients with heart failure and preserved ejection fraction: The Irbesartan in Heart Failure with Preserved Ejection Fraction (I-PRESERVE) trial
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Sex differences in clinical characteristics and outcomes in elderly patients with heart failure and preserved ejection fraction: The Irbesartan in Heart Failure with Preserved Ejection Fraction (I-PRESERVE) trial

机译：老年心力衰竭和射血分数保留患者的临床特征和结局的性别差异：厄贝沙坦治疗保留射血分数的心衰患者（I-PRESERVE）试验

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Background: There are few sex-specific outcome data in heart failure with preserved ejection fraction. Methods and Results: We assessed sex differences in baseline characteristics and outcomes among 4128 patients with heart failure with preserved ejection fraction in the Irbesartan in Heart Failure with Preserved Ejection Fraction (I-PRESERVE) trial. Women (n=2491) with heart failure with preserved ejection fraction were ≈1 year older (72±7 years versus 71±7 years) and more likely to be obese (46% versus 35%) and have chronic kidney disease (34% versus 26%) and hypertension (91% versus 85%) than men but less likely to have an ischemic cause (19% versus 34%), atrial fibrillation (27% versus 33%), or chronic obstructive pulmonary disease (8% versus 13%) (all P <0.001). During a mean of 49.5 months, there were 881 deaths (447 in women, 434 in men; risk ratio, 0.64;95% CI, 0.56-0.74) and 5776 hospitalizations (3239 in women, 2537 in men; risk ratio, 0.80;95% CI, 0.76-0.84). Women had lower risk of all-cause events (deaths and hospitalizations), even after adjusting for baseline characteristics (adjusted hazards ratio, 0.81;95% CI, 0.73-0.89). However, the sex-related difference in risk of all-cause events was modifed in the presence or absence of atrial fibrillation, renal dysfiunction, stable angina pectoris, or advanced New York Heart Association class symptoms. Conclusions: In patients with typical heart failure with preserved ejection fraction, there were prominent sex differences in baseline characteristics and outcomes. Women had better overall prognosis, although the presence of 4 common baseline characteristics seemed to moderate this finding. Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT000095238.
机译：背景：保留射血分数的心力衰竭的性别特定结果数据很少。方法和结果：我们评估了4128例心力衰竭患者中基线特征和预后的性别差异，该患者在厄贝沙坦的“保留射血分数的心衰”试验中得到了厄贝沙坦治疗。保留射血分数的心力衰竭妇女（n = 2491）约大1岁（72±7岁比71±7岁），更容易肥胖（46％比35％），患有慢性肾脏疾病（34％）与男性相比（26％）和高血压（91％与85％）和高血压（19％对34％），房颤（27％对33％）或慢性阻塞性肺疾病（8％对13％）（所有P <0.001）。在平均49.5个月内，有881例死亡（女性447例，男性434例;风险比，0.64; 95％CI，0.56-0.74）和5776例住院治疗（女性3239例，男性2537例;风险比，0.80;有3例）。 95％CI，0.76-0.84）。即使在调整了基线特征（调整后的危险比，0.81; 95％CI，0.73-0.89）之后，妇女的全因事件（死亡和住院）风险也较低。然而，在存在或不存在房颤，肾功能不全，稳定的心绞痛或纽约心脏协会晚期症状的情况下，性别相关的全因事件风险差异得到了改善。结论：典型心力衰竭患者射血分数保持不变，其基线特征和结局存在明显的性别差异。妇女的总体预后较好，尽管有四个共同的基线特征似乎可以缓和这一发现。临床试验注册：URL：http://www.clinicaltrials.gov。唯一标识符：NCT000095238。

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