Literature - Meyer S, Teerlink JR, Metra M, et al. - Clin Res Cardiol. 2017;106(4):280-292

Background

There are important gender-related differences regarding the onset of heart failure (HF), the features of established chronic HF, and the clinical characteristics at admission for acute HF [1,2]. Compared with men, women have more often hypertension, atriumfibrilleren, preserved left ventricle ejection fraction (LVEF), a longer length of hospitalization, and receive less diuretic medication, whereas men are more likely to have a history of myocardial infarction, reduced LVEF, and specific medical and device treatment [3,4].

In this analysis of the RELAX-AHF study [5,6], the gender differences in early and persistent dyspnea relief were investigated. Moreover, patient features and HF characteristics in men and women hospitalized for acute HF were analyzed.

Main results

• The change in dyspnea visual analog scale AUC from baseline to day 5 did not vary by gender.
• A significantly higher proportion of women had moderate or marked dyspnea improvement measured by the Likert scale during the first 24 h.
• There were higher general wellbeing Likert score values in women through 24 h and through 5 days.
• Women were treated with lower total IV and oral loop diuretic doses through day 5, but dyspnea improved earlier moderately or markedly through day 5 in women.
• There were no relevant gender differences regarding body weight changes, worsening of HF, or outcomes.
• Women showed a trend towards longer ICU/CCU stays (4.05 ± 7.67 days vs. 3.51 ± 6.63 days; P = 0.0248) and total initial hospital stays (10.37 ± 9.62 days vs. 9.87 ± 9.17 days; P = 0.0258) compared to men.
• Physician-assessed signs and symptoms of congestion, such as dyspnea on exertion, orthopnea, edema or rales, did not vary by treatment and gender.
• Women did not have different outcomes compared with men in any of the analyzed endpoints.
• The relationship of gender with outcomes did not vary by treatment with serelaxin or the presence of HFpEF.
• Using a multi-variable logistic regression model, male gender, age and total diuretic dose were independently and negatively associated with dyspnea improvement within 24 h.

Conclusion

References

Find this article online at Clin Res Cardiol.