Heart failure & cardiomyopathies
Sex-Based Differences in Chronic Heart Failure: a Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Systematic Review and Meta-Analysis of Randomized Controlled Trials
- random-effects models
- pre-specified subgroup analyses
+2 more
- random-effects models
- pre-specified subgroup analyses
Authors' conclusion
Women remain underrepresented in HF RCTs. Sex-stratified analyses suggest a potentially greater relative benefit of drug intervention in women, which might inform future RCTs. Further studies are required to investigate the mechanisms of these differences.
Study context
- Population
- Randomized controlled trials (RCTs) enrolling patients with chronic heart failure (HF), pharmacological or device-based interventions with a hard primary endpoint (mortality and hospitalization) and reporting enrollment of womendrug 39 · device 17
- Participants
- 56 RCTs
- Comparison
- Sex-specific treatment effects
Pooled result
As reported in the abstract
Drug trials
27.0%
95%CI 22.0% to 32.4%
Device trials
25.3%
95%CI 21.0% to 29.9%
Further pooled results
Women enrollment, HFrEF vs HFpEF trials · Women were more underrepresented in HFrEF
P < 0.001
Pooled sex interaction, drug trials
- RCTs reporting HR
- 0.94 (95%CI 0.89-1.01)
- RCTs reporting RR
- 0.81 (95%CI 0.68-0.96)
- Suggesting potentially greater benefit for women
Interaction between HF with reduced ejection fraction (HFrEF) and HF with preserved EF (HFpEF) trials, drug trials
- No interaction, HR
- P = 0.44
- No interaction, RR
- P = 0.95
Pooled interaction estimate on event counts
- Pooled interaction estimate on event counts
- 0.90 (95%CI 0.84-0.96)
Pooled sex interaction, device trials
- RCTs reporting HR
- 1.05 (95%CI 0.90-1.22)
- RCTs reporting RR
- 0.68 (95%CI 0.50-0.93)
Original publication
Summarised from the published abstract; every number is checked against it