Loading...
Neurohormonal and clinical sex differences in heart failure
Meyer, Sven van der Meer, Peter van Deursen, Vincent Jaarsma, Tiny van Veldhuisen, Dirk van der Wal, Martje Hillege, Hans Voors, Adriaan
Meyer, Sven
van der Meer, Peter
van Deursen, Vincent
Jaarsma, Tiny
van Veldhuisen, Dirk
van der Wal, Martje
Hillege, Hans
Voors, Adriaan
Abstract
Aims: Despite disparities in pathophysiology and disease manifestation between male and female patients with heart failure, studies focusing on sex differences in biomarkers are scarce. The purpose of this study was to assess sex-specific variation in clinical characteristics and biomarker levels to gain more understanding of the potential pathophysiological mechanisms underlying sex differences in heart failure. Methods and results: Baseline demographic and clinical characteristics, multiple biomarkers, and outcomes were compared between men and women in 567 patients. The mean age of the study group was 71 ± 11 years and 38% were female. Women were older, had a higher body mass index and left ventricular ejection fraction, more hypertension, and received more diuretic and antidepressant therapy, but less ACE-inhibitor therapy compared with men. After 3 years, all-cause mortality was lower in women than men (37.0 vs. 43.9%, multivariable hazard ratio = 0.64; 95% confidence interval 0.45–0.92, P = 0.016). Levels of biomarkers related to inflammation [C-reactive protein, pentraxin 3, growth differentiation factor 15 (GDF-15), and interleukin 6] and extracellular matrix remodelling (syndecan-1 and periostin) were significantly lower in women compared with men. N-terminal pro-brain natriuretic peptide, TNF-αR1a, and GDF-15 showed the strongest interaction between sex and mortality. Conclusion: Female heart failure patients have a distinct clinical presentation and better outcomes compared with male patients. The lower mortality was independent of differences in clinical characteristics, but differential sex associations between several biomarkers and mortality might partly explain the survival difference.
Keywords
Date
2013
Type
Journal article
Journal
European Heart Journal (English Edition)
Book
Volume
34
Issue
32
Page Range
2538-2547
Article Number
ACU Department
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled