• Hyun-Jin Kim, Myung-A Kim, Hack-Lyoung Kim, Dong-Ju Choi, Seongwoo Han, Eun-Seok Jeon, Myeong-Chan Cho, Jae-Joong Kim, Byung-Su Yoo, Mi-Seung Shin, Seok-Min Kang, and Shung Chull Chae.
• Cardiovascular center, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
• Eur. J. Clin. Invest. 2020 May 1; 50 (5): e13232.

BackgroundAlthough the impact of ischaemic heart disease (IHD) on heart failure (HF) is evolving, there is uncertainty about the role of IHD in determining the risk of clinical outcomes by gender. This study evaluated the gender difference in the impact of IHD on long-term clinical outcomes in patients with heart failure reduced ejection fraction (HFrEF).MethodsStudy data were obtained from a nationwide registry, which is a prospective multicentre cohort that included 3200 patients who were hospitalized for HF. A total of 1638 patients with HFrEF were classified by gender. The primary outcome was all-cause death during follow-up.ResultsIn total, 133 women (18.9%) died and 168 men (18.0%) died during the follow-up (median, 489 days). Women with HFrEF with IHD had a significantly lower cumulative survival rate than women without IHD at the long-term follow-up (74.8% vs 84.9%, log-rank P = .001). However, the survival rate was not different in men with HFrEF with IHD compared with men without IHD. A Cox regression analysis showed that IHD had a 1.43-fold increased risk for all-cause mortality independently in women after adjusting for confounding factors (odds ratio 1.43, 95% confidence interval 1.058-1.929, P = .020).ConclusionIschaemic heart disease was an independent risk factor for long-term mortality in women with HFrEF. IHD should be actively evaluated in women with HF for predicting clinical outcomes and initiating appropriate treatment. Women with HF caused by IHD should be treated more meticulously to avoid a poor prognosis.© 2020 Stichting European Society for Clinical Investigation Journal Foundation.

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