Gender-Related Differences in Patients with Acute Heart Failure: Observation from the Journey Heart Failure-Turkish Population Study

Background: Gender-related clinical variations in patients with acute heart failure have been described in previous studies. However, there is still a lack of research on gender differences in patients hospitalized for acute heart failure in Türkiye. The aim of this study is to compare the clinical features, in-hospital approaches, and outcomes of male and female patients hospitalized for acute heart failure.

Methods: Differences in clinical characteristics, medication prescription, hospital management, and outcomes between males and females with acute heart failure were investigated from the Journey Heart Failure-Turkish Population study.

Results: Nine hundred eighteen patients (57.2%) were men and 688 (42.8%) were women. Women were older than men (70.48 ± 13.20 years vs. 65.87 ± 12.82 years; P <.001). The frequency of comorbidities such as hypertension (72.7% vs. 62.4%, P <.001), diabetes (46.5% vs. 38.5%, P = .001),  atrial  fibrillation  (46.5%  vs.  33.4%,  P <.001), New York Heart Association class III-IV symptoms (80.6% vs. 71.2%, P =.001), and dyspnea in the rest (73.8% vs. 68.3%, P =.044) were more common in women on admission. Male patients were more frequently hospitalized with reduced left ventricular ejection fraction (51.0% vs. 72.4%, P <.001). In-hospital mortality was higher among female patients (9.3% vs. 6.4%, P =.022). Higher  New  York  Heart  Association  class,  lower  estimated  glomerular  filtration  rate, higher N-terminal pro-B type natriuretic peptide on admission, and mechanical ventilation usage were the independent parameters of in-hospital mortality, whereas the female gender was not.

Conclusion: Our study clearly demonstrated the diversity in presentation, management, and in-hospital outcomes of acute heart failure between male and female patients. Although left ventricular systolic functions were better in female patients, in-hospital mortality was higher. Recognizing these differences in the management of heart failure in different sexes will serve better results in clinical practice.