Heart failure & cardiomyopathiesCohort study
Sex-related disparities in elderly patients with heart failure with mildly reduced or preserved ejection fraction
- observational, ambispective study
- single hospital (Papa Giovanni XXIII Hospital, Bergamo)
- validated in the Swedish HF registry
Authors' conclusion
This study highlights significant sex disparities in elderly HFmrEF/HFpEF patients, with higher age and male sex being an independent predictor for poor outcomes. These findings emphasize the need for personalized treatment strategies based on these demographic factors.
Study context
- Population
- Patients >65 years with HFmrEF/HFpEF (New York Heart Association (NYHA) Class II–IV) according to ESC guidelines, June 2017 to August 2022HFmrEF/HFpEF patients analysed, among 2263 HF patients, 56.8% males, mean age 79.2 years · Bergamo cohort 971 · SwedeHF validation cohort 20,950
- Participants
- 971 patients
- Exposure
- Males compared with women; patients >80 years old compared with those aged 65-70
Main finding
As reported in the abstract
Composite of:
- All-cause death
- Urgent heart transplant
- HF hospitalization
- Emergency department referral for decompensated HF
Incidence rate ratio
1.20
P = 0.035
By group
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Independent predictors of worse outcomes (multivariable analysis) — Males vs women · 40% higher risk | 1.40 (1.13–1.73) | |
| Independent predictors of worse outcomes (multivariable analysis) — age >80 years vs aged 65-70 · nearly double the risk | 1.91 (1.22–3.00) | |
| 0.20.5125Hazard ratio (log scale) |
Independent predictors of worse outcomes (multivariable analysis)
- higher NYHA class, chronic kidney disease, and severe valvular heart disease as independent predictors of worse outcomes
Cardiovascular risk factors
- Males had a higher prevalence of cardiovascular risk factors (e.g. diabetes, obesity, coronary artery disease)
Validation in SwedeHF · January 2017 and August 2022
- similar independent risk factors for the composite outcome
- 20 950 selected patients, median age 79 years and 57.8% men
Original publication
Sex-related disparities in elderly patients with heart failure with mildly reduced or preserved ejection fraction. ESC Heart Fail. Published 8 January 2026. doi:10.1093/eschf/xvaf022
Summarised from the published abstract; every number is checked against it