Sex-Based Differences in Heart Failure Management and Outcomes: Insights from the French-DataHF Cohort

作者：Guillaume Baudry, Ouarda Pereira, François Roubille, Marc Villacèque, Thibaud Damy, Kevin Duarte, Philippe Tangre, Nicolas Girerd · 发表于：European Journal of Heart Failure · 年份：2025 · DOI：10.1002/ejhf.3733 · 被引用次数：9 · 研究领域：Heart Failure Treatment and Management、Acute Myocardial Infarction Research、Sex and Gender in Healthcare

AIMS: Heart failure (HF) prognosis is influenced by demographic, clinical, and healthcare-related factors, with sex playing a crucial role. However, sex-based differences in HF management and outcomes remain insufficiently characterized in real-world settings. This study aimed to assess sex-related disparities in HF prognosis and management using a comprehensive nationwide cohort. METHODS AND RESULTS: This study utilized the French-DataHF cohort, including all French patients diagnosed with HF in the previous 5 years and alive on 1 January 2020. Inverse probability weighting (IPW) was applied to adjust for baseline differences in assessing prognosis and management. The primary outcome was all-cause mortality (ACM), while secondary outcomes included HF hospitalization and their composite. Survival analyses were performed using Cox proportional hazards models, adjusted for demographic, clinical, and healthcare factors. The study included 655 919 patients (48% female). One-year ACM was 16.8% in females vs. 15.1% in males. In IPW-adjusted analyses, females received less renin-angiotensin system inhibitors (52.8% vs. 61.5%), while a higher proportion had no annual cardiology follow-up (33.8% vs. 27.9%). In the fully adjusted model, females had a 21% lower ACM risk (adjusted hazard ratio [aHR] 0.79, 95% confidence interval [CI] 0.79-0.80) and a 15% lower composite outcome risk (aHR 0.85, 95% CI 0.85-0.86). Cardiology follow-up was associated with lower ACM risk across sexes, with a...