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Title: Impact of sex on heart failure pharmacotherapy and outcomes in patients with ischaemic heart disease and comorbid heart failure with reduced ejection fraction.
Author: Dagan, M.
Dinh, D.
Stehli, J.
Tan, C.
Brennan, A.
Ajani, A.
Oqueli, Ernesto
Kaye, D.
Freeman, M.
Reid, C.
Hiew, C.
Clark, D.
Duffy, S.
Issue Date: 2020
Conference Name: 68th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, the International Society for Heart Research Australasian Section Annual Scientific Meeting and the 14th Annual Australia and New Zealand Endovascular Therapies Meeting
Conference Date: December 11-13
Conference Place: Online
Abstract: Background/Aims: In clinical practice, women are less often on guideline-directed medical therapy. We aimed to investigate if a sex discrepancy exists for optimal medical therapy (OMT) and long-term mortality in patients with known ischaemic heart disease (IHD) and comorbid heart failure with reduced ejection fraction (HFrEF). Methods: We analysed data on pharmacotherapy 30 days post-percutaneous coronary intervention from a prospectively collected multicentre registry in patients with IHD and pre-existing or newly diagnosed HFrEF between 2005-2018. OMT was defined as beta-blocker (BB), angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEi/ARB)±mineralocorticoid receptor antagonist (MRA). Long-term mortality was obtained via linkage with the National Death Index. Results: Women accounted for 24% (372/1,567), and were on average 3-years older (71±12 vs 68±11 years) than men. Women had higher rates of hypertension, renal dysfunction and rheumatoid arthritis. Overall, 74% (1,160) of patients were on OMT, with similar rates between sexes (76.6% vs 73.2%, p=0.19). Women were more likely to be on a BB (89.3% vs 84.9%, p=0.04), while rates of ACEi/ARB (78.2% vs 80.8%, p=0.29) and MRA (26.3% vs 29.4%, p=0.27) were similar between sexes. At 30 days, rates of arrhythmia (p<0.001) and recurrent myocardial infarction (p=0.003) were higher amongst women. Mortality was higher for both sexes on sub-optimal medical therapy (SMT), however, there was no difference in long-term mortality (median 3.7 years) between sexes (figure). Conclusion: Amongst patients with IHD and comorbid HFrEF, women had similar rates of OMT and similar long-term mortality compared to men.
Internal ID Number: 01641
Type: Conference
Appears in Collections:Research Output

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