Relation between gender, etiology and survival in patients with symptomatic heart failure

Kirkwood F. Adams, Stephanie H. Dunlap, Carla A. Sueta, Susan W. Clarke, James Herbert Patterson, Mary Beth Blauwet, Lynda R. Jensen, Lisa Tomasko, Gary Koch

Research output: Contribution to journalArticlepeer-review

250 Scopus citations


Objectives. This study investigated the relation between gender, etiology and survival in patients with symptomatic heart failure. Background. Previous work provides conflicting results concerning the relation between gender, clinical characteristics and survival in patients with heart failure. Methods. We examined the relation of these factors in 557 patients (380 men, 177 women) who had symptomatic heart failure, predominantly nonischemic in origin (68%) and typically associated with severe left ventricular dysfunction. Results. Follow-up data were available in 99% of patients (mean follow-up period 2.4 years, range 1 day to 10 years) after study entry, and 201 patients reached the primary study end point of all-cause mortality. By life-table analysis, women were significantly less likely to reach this primary end point than men (p < 0.001). A significant association was found between female gender and better survival (p < 0.001), which depended on the primary etiology of heart failure (p = 0.008 for the gender-etiology interaction) but not on baseline ventricular function. Women survived longer than men when heart failure was due to nonischemic causes (men vs. women: relative risk [RR] 2.36, 95% confidence interval [CI] 1.59 to 3.51, p < 0.001). In contrast, outcome appeared similar when heart failure was due to ischemic heart disease (men vs. women: RR 0.85, 95% CI 0.45 to 1.61, p = 0.651). Conclusions. Women with heart failure due to nonischemic causes had significantly better survival than men with or without coronary disease as their primary cause of heart failure.

Original languageEnglish (US)
Pages (from-to)1781-1788
Number of pages8
JournalJournal of the American College of Cardiology
Issue number7
StatePublished - Dec 1997
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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