Gender and survival in patients with heart failure: interactions with diabetes and aetiology. Results from the MAGGIC individual patient meta-analysis

Manuel Martínez-Sellés; Robert N Doughty; Katrina Poppe; Gillian A Whalley; Nikki Earle; Christophe Tribouilloy; John J V McMurray; Karl Swedberg; Lars Køber; Colin Berry; Iain Squire; Meta-Analysis Global Group In Chronic Heart Failure (MAGGIC); Søren Boesgaard; Olav Wendelboe Nielsen; Christian Tobias Torp-Pedersen

doi:10.1093/eurjhf/hfs026

Gender and survival in patients with heart failure: interactions with diabetes and aetiology. Results from the MAGGIC individual patient meta-analysis

Manuel Martínez-Sellés, Robert N Doughty, Katrina Poppe, Gillian A Whalley, Nikki Earle, Christophe Tribouilloy, John J V McMurray, Karl Swedberg, Lars Køber, Colin Berry, Iain Squire, Meta-Analysis Global Group In Chronic Heart Failure (MAGGIC), Søren Boesgaard, Olav Wendelboe Nielsen, Christian Tobias Torp-Pedersen

101 Citations (Scopus)

Abstract

Aim The aim of this study was to investigate the relationship between gender and survival of patients with heart failure, using data from both randomized trials and observational studies, and the relative contribution of age, left ventricular systolic function, aetiology, and diabetes to differences in prognosis between men and women. Methods and results Data from 31 studies (41 949 patients; 28 052 men, 13 897 women) from the Meta-Analysis Global Group In Chronic Heart Failure (MAGGIC) individual patient meta-analysis were used. We performed survival analysis to assess the association of gender with mortality, adjusting for predictors of mortality, including age, reduced or preserved ejection fraction (EF), and ischaemic or non-ischaemic aetiology. Women were older [70.5 (standard deviation 12.1) vs. 65.6 (standard deviation 11.6) years], more likely to have a history of hypertension (49.9% vs. 40.0%), and less likely to have a history of ischaemic heart disease (46.3% vs. 58.7%) and reduced EF (62.6% vs. 81.6%) compared with men. During 3 years follow-up, 3521 (25%) women and 7232 (26%) men died. After adjustment, male gender was an independent predictor of mortality, and the better prognosis associated with female gender was more marked in patients with heart failure of non-ischaemic, compared with ischaemic, aetiology (P-value for interaction = 0.03) and in patients without, compared with those with, diabetes (P-value for interaction <0.0001). Conclusion This large, individual patient data meta-analysis has demonstrated that survival is better for women with heart failure compared with men, irrespective of EF. This survival benefit is slightly more marked in non-ischaemic heart failure but is attenuated by concomitant diabetes.

Original language	English
Journal	European Journal of Heart Failure
Volume	14
Issue number	5
Pages (from-to)	473-9
Number of pages	7
ISSN	1388-9842
DOIs	https://doi.org/10.1093/eurjhf/hfs026
Publication status	Published - May 2012

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10.1093/eurjhf/hfs026

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Martínez-Sellés, M., Doughty, R. N., Poppe, K., Whalley, G. A., Earle, N., Tribouilloy, C., McMurray, J. J. V., Swedberg, K., Køber, L., Berry, C., Squire, I., Meta-Analysis Global Group In Chronic Heart Failure (MAGGIC), Boesgaard, S., Wendelboe Nielsen, O., & Torp-Pedersen, C. T. (2012). Gender and survival in patients with heart failure: interactions with diabetes and aetiology. Results from the MAGGIC individual patient meta-analysis. European Journal of Heart Failure, 14(5), 473-9. https://doi.org/10.1093/eurjhf/hfs026

Gender and survival in patients with heart failure : interactions with diabetes and aetiology. Results from the MAGGIC individual patient meta-analysis. / Martínez-Sellés, Manuel; Doughty, Robert N; Poppe, Katrina et al.

In: European Journal of Heart Failure, Vol. 14, No. 5, 05.2012, p. 473-9.

Research output: Contribution to journal › Journal article › Research › peer-review

Martínez-Sellés, M, Doughty, RN, Poppe, K, Whalley, GA, Earle, N, Tribouilloy, C, McMurray, JJV, Swedberg, K, Køber, L, Berry, C, Squire, I, Meta-Analysis Global Group In Chronic Heart Failure (MAGGIC), Boesgaard, S, Wendelboe Nielsen, O & Torp-Pedersen, CT 2012, 'Gender and survival in patients with heart failure: interactions with diabetes and aetiology. Results from the MAGGIC individual patient meta-analysis', European Journal of Heart Failure, vol. 14, no. 5, pp. 473-9. https://doi.org/10.1093/eurjhf/hfs026

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title = "Gender and survival in patients with heart failure: interactions with diabetes and aetiology. Results from the MAGGIC individual patient meta-analysis",

abstract = "Aim The aim of this study was to investigate the relationship between gender and survival of patients with heart failure, using data from both randomized trials and observational studies, and the relative contribution of age, left ventricular systolic function, aetiology, and diabetes to differences in prognosis between men and women. Methods and results Data from 31 studies (41 949 patients; 28 052 men, 13 897 women) from the Meta-Analysis Global Group In Chronic Heart Failure (MAGGIC) individual patient meta-analysis were used. We performed survival analysis to assess the association of gender with mortality, adjusting for predictors of mortality, including age, reduced or preserved ejection fraction (EF), and ischaemic or non-ischaemic aetiology. Women were older [70.5 (standard deviation 12.1) vs. 65.6 (standard deviation 11.6) years], more likely to have a history of hypertension (49.9% vs. 40.0%), and less likely to have a history of ischaemic heart disease (46.3% vs. 58.7%) and reduced EF (62.6% vs. 81.6%) compared with men. During 3 years follow-up, 3521 (25%) women and 7232 (26%) men died. After adjustment, male gender was an independent predictor of mortality, and the better prognosis associated with female gender was more marked in patients with heart failure of non-ischaemic, compared with ischaemic, aetiology (P-value for interaction = 0.03) and in patients without, compared with those with, diabetes (P-value for interaction <0.0001). Conclusion This large, individual patient data meta-analysis has demonstrated that survival is better for women with heart failure compared with men, irrespective of EF. This survival benefit is slightly more marked in non-ischaemic heart failure but is attenuated by concomitant diabetes.",

author = "Manuel Mart{\'i}nez-Sell{\'e}s and Doughty, {Robert N} and Katrina Poppe and Whalley, {Gillian A} and Nikki Earle and Christophe Tribouilloy and McMurray, {John J V} and Karl Swedberg and Lars K{\o}ber and Colin Berry and Iain Squire and Torp-Pedersen, {Christian Tobias} and S{\o}ren Boesgaard and {Wendelboe Nielsen}, Olav and Torp-Pedersen, {Christian Tobias}",

year = "2012",

month = may,

doi = "10.1093/eurjhf/hfs026",

language = "English",

volume = "14",

pages = "473--9",

journal = "European Journal of Heart Failure, Supplement",

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TY - JOUR

T1 - Gender and survival in patients with heart failure

T2 - interactions with diabetes and aetiology. Results from the MAGGIC individual patient meta-analysis

AU - Martínez-Sellés, Manuel

AU - Doughty, Robert N

AU - Poppe, Katrina

AU - Whalley, Gillian A

AU - Earle, Nikki

AU - Tribouilloy, Christophe

AU - McMurray, John J V

AU - Swedberg, Karl

AU - Køber, Lars

AU - Berry, Colin

AU - Squire, Iain

AU - Meta-Analysis Global Group In Chronic Heart Failure (MAGGIC)

AU - Boesgaard, Søren

AU - Wendelboe Nielsen, Olav

AU - Torp-Pedersen, Christian Tobias

PY - 2012/5

Y1 - 2012/5

N2 - Aim The aim of this study was to investigate the relationship between gender and survival of patients with heart failure, using data from both randomized trials and observational studies, and the relative contribution of age, left ventricular systolic function, aetiology, and diabetes to differences in prognosis between men and women. Methods and results Data from 31 studies (41 949 patients; 28 052 men, 13 897 women) from the Meta-Analysis Global Group In Chronic Heart Failure (MAGGIC) individual patient meta-analysis were used. We performed survival analysis to assess the association of gender with mortality, adjusting for predictors of mortality, including age, reduced or preserved ejection fraction (EF), and ischaemic or non-ischaemic aetiology. Women were older [70.5 (standard deviation 12.1) vs. 65.6 (standard deviation 11.6) years], more likely to have a history of hypertension (49.9% vs. 40.0%), and less likely to have a history of ischaemic heart disease (46.3% vs. 58.7%) and reduced EF (62.6% vs. 81.6%) compared with men. During 3 years follow-up, 3521 (25%) women and 7232 (26%) men died. After adjustment, male gender was an independent predictor of mortality, and the better prognosis associated with female gender was more marked in patients with heart failure of non-ischaemic, compared with ischaemic, aetiology (P-value for interaction = 0.03) and in patients without, compared with those with, diabetes (P-value for interaction <0.0001). Conclusion This large, individual patient data meta-analysis has demonstrated that survival is better for women with heart failure compared with men, irrespective of EF. This survival benefit is slightly more marked in non-ischaemic heart failure but is attenuated by concomitant diabetes.

AB - Aim The aim of this study was to investigate the relationship between gender and survival of patients with heart failure, using data from both randomized trials and observational studies, and the relative contribution of age, left ventricular systolic function, aetiology, and diabetes to differences in prognosis between men and women. Methods and results Data from 31 studies (41 949 patients; 28 052 men, 13 897 women) from the Meta-Analysis Global Group In Chronic Heart Failure (MAGGIC) individual patient meta-analysis were used. We performed survival analysis to assess the association of gender with mortality, adjusting for predictors of mortality, including age, reduced or preserved ejection fraction (EF), and ischaemic or non-ischaemic aetiology. Women were older [70.5 (standard deviation 12.1) vs. 65.6 (standard deviation 11.6) years], more likely to have a history of hypertension (49.9% vs. 40.0%), and less likely to have a history of ischaemic heart disease (46.3% vs. 58.7%) and reduced EF (62.6% vs. 81.6%) compared with men. During 3 years follow-up, 3521 (25%) women and 7232 (26%) men died. After adjustment, male gender was an independent predictor of mortality, and the better prognosis associated with female gender was more marked in patients with heart failure of non-ischaemic, compared with ischaemic, aetiology (P-value for interaction = 0.03) and in patients without, compared with those with, diabetes (P-value for interaction <0.0001). Conclusion This large, individual patient data meta-analysis has demonstrated that survival is better for women with heart failure compared with men, irrespective of EF. This survival benefit is slightly more marked in non-ischaemic heart failure but is attenuated by concomitant diabetes.

U2 - 10.1093/eurjhf/hfs026

DO - 10.1093/eurjhf/hfs026

M3 - Journal article

C2 - 22402958

SN - 1567-4215

VL - 14

SP - 473

EP - 479

JO - European Journal of Heart Failure, Supplement

JF - European Journal of Heart Failure, Supplement

IS - 5

ER -

Gender and survival in patients with heart failure: interactions with diabetes and aetiology. Results from the MAGGIC individual patient meta-analysis

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