Influence of Gender in Advanced Heart Failure Therapies and Outcome Following Transplantation

Frontiers in Cardiovascular Medicine

Eduardo Barge-Caballero¹  Manuel Martínez-Selles²  Manuel Gómez Bueno³  María Dolores García-Cosío⁴  Juan F. Delgado⁵  Félix Pérez-Villa⁶  Luis de la Fuente Galán⁷  Sonia Mirabet⁸  José González-Costello⁹  Raquel López-Vilella^1,10  Beatriz Díaz Molina^1,11  Francisco González-Vilchez^1,12  Ana Portolés Ocampo^1,13  Jose María Arizón^1,14  Iris Garrido^1,15  Diego Rangel Sousa^1,16  Gregorio Rábago^1,17 

[1] Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain;Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain;Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain;Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Universidad Europea, Universidad Complutense, Madrid, Spain;Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain;Servicio de Cardiología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain;Servicio de Cardiología, Hospital 12 de Octubre Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain;Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain;Servicio de Cardiología, Hospital 12 de Octubre Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain;Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain;Departamento de Medicina, Universidad Complutense de Madrid, Madrid, Spain;Servicio de Cardiología, Hospital Clínic i Provincial, Barcelona, Spain;Servicio de Cardiología, Hospital Clínico Universitario De Valladolid, Valladolid, Spain;Servicio de Cardiología, Hospital Santa Creu i Sant Pau, Barcelona, Spain;Servicio de Cardiología, Hospital Universitari De Bellvitge, Hospitalet de Llobregat, Spain;Servicio de Cardiología, Hospital Universitari i Politecnic La Fe, Valencia, Spain;Servicio de Cardiología, Hospital Universitario Central De Asturias, Oviedo, Spain;Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain;Servicio de Cardiología, Hospital Universitario Miguel Servet, Zaragoza, Spain;Servicio de Cardiología, Hospital Universitario Reina Sofía, Cordoba, Spain;Servicio de Cardiología, Hospital Universitario Virgen De La Arrixaca, Murcia, Spain;Servicio de Cardiología, Hospital Universitario Virgen Del Rocío, Seville, Spain;Servicio de Cirugía Cardiaca, Clínica Universidad De Navarra, Navarra, Spain;

关键词: gender;    female;    heart transplantation;    outcome;    women;    advanced heart failure;    ventricular assist device;   

DOI  :  10.3389/fcvm.2021.630113

来源: Frontiers

【 摘 要 】

Biological differences between males and females change the course of different diseases and affect therapeutic measures' responses. Heart failure is not an exception to these differences. Women account for a minority of patients on the waiting list for heart transplantation or other advanced heart failure therapies. The reason for this under-representation is unknown. Men have a worse cardiovascular risk profile and suffer more often from ischemic heart disease. Conversely, transplanted women are younger and more frequently have non-ischemic cardiac disorders. Women's poorer survival on the waiting list for heart transplantation has been previously described, but this trend has been corrected in recent years. The use of ventricular assist devices in women is progressively increasing, with comparable results than in men. The indication rate for a heart transplant in women (number of women on the waiting list for millions of habitants) has remained unchanged over the past 25 years. Long-term results of heart transplants are equal for both men and women. We have analyzed the data of a national registry of heart transplant patients to look for possible future directions for a more in-depth study of sex differences in this area. We have analyzed 1-year outcomes of heart transplant recipients. We found similar results in men and women and no sex-related interactions with any of the factors related to survival or differences in death causes between men and women. We should keep trying to approach sex differences in prospective studies to confirm if they deserve a different approach, which is not supported by current evidence.

【 授权许可】

CC BY