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Survival Of CHFers By Sex

December 17, 2003 - We studied how gender influences heart
failure patients. We specifically studied the effect of sex
on characteristics at diagnosis, response to treatment, and
prognosis in CHFers with reduced EF.
	We used information from BEST - Beta-Blocker
Evaluation of Survival Trial. That study had 2708 class 3 to
class 4 CHFers with EF averaging 35%, taking bucindolol or
placebo. 593 women were compared to 2115 men. Average follow-
up was 2 years.
	At treatment start, women were younger, more likely
to be black, more had nonischemic cause of CHF, higher right
and left EF, faster heart rate, larger heart size compared to
their chest size (greater cardiothoracic ratio), more left
bundle branch block, less a-fib, and lower blood
norepinephrine level.
	Ischemic cause of CHF and worse symptoms predicted
higher risk of death in both women and men. Differences were
seen, though.
	Blocked arteries (CAD) and low EF raised risk of death
more in women. In nonischemic patients (those without blocked
arteries), women were much more likely to survive.
	We conclude that in heart failure patients with
reduced EF, gender makes a difference. Women without CAD
(Coronary Artery Disease) are more likely to survive than men
with CAD.

Source:  J Am Coll Cardiol 17 December 2003, Volume 42,
         Issue 12, Pages 2128-2134
Title:   Gender differences in advanced heart failure: insights
         from the BEST study.
Authors: Jalal K. Ghali, Heidi J. Krause-Steinrauf, Kirkwood F.
         Adams, Steven S. Khan, Yves D. Rosenberg, Clyde W.
         Yancy, James B. Young, Steven Goldman, Mary Ann Peberdy,
         JoAnn Lindenfeld.