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Sex differences on new-onset heart failure in patients with known or suspected coronary artery disease.

Fecha de publicación: Fecha Ahead of Print:

Autores de INCLIVA

Participantes ajenos a INCLIVA

  • Monmeneu, Jose V
  • Lopez-Lereu, Maria P
  • Perez, Nerea
  • Nunez, Eduardo
  • Bayes-Genis, Antoni

Grupos y Plataformas de I+D+i

Abstract

AIMS: The impact of sex in patients with CAD has been widely reported, but little is known about the influence of sex on the risk of new-onset HF in patients with known or suspected CAD. We aimed to examine sex-related differences and new-onset heart failure (HF) risk in patients with known or suspected coronary artery disease (CAD) undergoing vasodilator stress cardiac magnetic resonance (CMR). METHODS AND RESULTS: We prospectively evaluated 5899 consecutive HF-free patients submitted to stress CMR for known or suspected CAD. Ischaemic burden (number of segments with stress-induced perfusion deficit) and left ventricular ejection fraction (LVEF) were assessed by CMR. The association between sex and new-onset HF (including outpatient diagnosis or acute HF hospitalization) was evaluated using a Cox proportional hazards regression model adjusted for competing events [death, myocardial infarction (MI), and revascularization]. A total of 2289 (38.8%) patients were women. During a median follow-up of 4.5 years, 610 (10.3%) patients died, 191 (3.2%) suffered an MI, 905 (15.3%) underwent revascularization, and 314 (5.3%) developed new-onset HF. Unadjusted new-onset HF rates were higher in women than in men (1.25 vs. 0.83 per 100 person-years, P = 0.001). After comprehensive multivariate adjustment, women showed an increased risk of new-onset HF (hazard ratio 1.58, 95% confidence interval 1.18-2.10; P = 0.002). We found a sex-differential effect along the continuum of LVEF (P-value for interaction = 0.007). At lower LVEF, there was an increased risk in both sexes. However, compared with men, the risk of new-onset HF was higher in women with LVEF >55%. CONCLUSION: Women with known or suspected CAD are at a higher risk of new-onset HF. Further studies are needed to unravel the mechanisms behind these sex-related differences.

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.

Datos de la publicación

ISSN/ISSNe:
2047-4873, 2047-4881

European Journal of Preventive Cardiology  SAGE PUBLICATIONS LTD

Tipo:
Article
Páginas:
1711-1719
PubMed:
33970216

Citas Recibidas en Web of Science: 19

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Métricas

Filiaciones mostrar / ocultar

Keywords

  • Cardiac magnetic resonance; Coronary artery disease; Heart failure; Sex

Campos de Estudio

Financiación

INSTITUTO SALUD CARLOS III (CB16/11/00420)
INSTITUTO SALUD CARLOS III (CB16/11/00486)
INSTITUTO SALUD CARLOS III (PI17/01836)
INSTITUTO SALUD CARLOS III (PI20/00637)

Proyectos y Estudios Clínicos

INCORPORACIÓN DE NUEVAS ÁREAS TEMÁTICAS Y NUEVOS GRUPOS AL CONSORCIO CIBER

Investigador Principal: VICENT BODÍ PERIS

CB16/11/00486 . INSTITUTO SALUD CARLOS III

INCORPORACIÓN DE NUEVAS ÁREAS TEMÁTICAS Y NUEVOS GRUPOS AL CONSORCIO CIBER

Investigador Principal: JUAN SANCHIS FORES

CB16/11/00420 . INSTITUTO SALUD CARLOS III

Estudio multidisciplinar de la obstrucción microvascular y su reparación tras un infarto agudo de miocardio: de la arteria coronaria a la microcirculación. Foco en el factor VEGF-A165b (PI17/01836).

Investigador Principal: VICENT BODÍ PERIS

PI17/01836 . INSTITUTO SALUD CARLOS III . 2018

Resolution of microvascular obstruction after myocardial infarction. A multidisciplinary approach to assess the structural and clinical consequences and to evaluate new therapeutic options.

Investigador Principal: VICENT BODÍ PERIS

PI20/00637 . INSTITUTO SALUD CARLOS III . 2021

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