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Gender-related differences in laboratory tests and precipitating factors in patiens with heart failure

Heart failure (HF) could be different in males and females. The aim of the study was to analyse gender related differences in precipitating factors and laboratory tests in HF patients. Results: We analyzed 2203 HF patients (from in- hospital Registry established in 2005): median age 76 y, 1175 (53.3%) males (m) and 1028 (46.7%) females (f). One third patients had acute (de novo) HF. Preserved left ventricular systolic function (LVEF≥50%) was recorded in 37.8% patients. Males had frequently reduced LVEF (<50%) (m-70.7%, f-50.7%) and females-preserved LVEF (≥50%) (f-49.3%, m-29.3%, p<0.001). History of hypertension (AH) was recorded in 67.5% patients, diabetes mellitus (DM) in 34.4%, myocardial infarction in 22.7%, renal insufficiency in 19.2%, COPD in 17.3%, and cerebrovascular disease in 16.5% patients. Atrial fibrillation (AF) or undulation (AU) was noted in 53.7% patients. COPD was important co-morbidities in males (m-19.7%, f-14.7%, p=0.009) as well as renal insufficiency (m-23%, f-14.8%, p<0.001). Males were frequently smokers (m-14.8%, f-6.4%, p= <0.001). Lower levels of haemoglobin was recorded in 51.9% patients, higher levels of creatinine in 46.8%, ALT in 29.8%, cholesterol in 32.7%, tryglicerides in 31.9%, uric acid in 79.3% and hyperglycaemia in 99.8% patients. Males had lower haemoglobin levels (m-58%, f-44.8%, p≤0.001) and females had higher values of ALT (f-33%, m-27%, p=0.012), cholesterol (f-36.8%, m-29.1%, p=0.009), tryglicerides (f- 36.1%, m-28.3%, p=0.014), and uric acid (f-82.9%, m-76.4%, p=0.007). The frequent precipitating factors of HF were hypertension (55.5% patients), arrhythmia (51.3%), acute coronary sindrom (ACS)(19.7%), and infections (19.6%). ACS was important HF "trigger" in males (m-22.1%, f-17%, p=0.010), and hypertension in females (f-58.7%, m-52.7%, p=0.009). Overall in-hospital mortality was 13.8% (m-12.6%, f-14.4%). Conclusion: Males had frequently reduced LVEF and females-preserved LVEF. Males had lower haemoglobin level, and females had higher levels of ALT, cholesterol, tryglicerides and uric acid. The leading HF "triggers" were hypertension, arrhythmia, ACS and infections. ACS was important "trigger" in males, and hypertension in females.

Heart failure; gender; risk factors.

doi:10.1093/eurjhf/hst009