Ambulatory Advanced Heart Failure in Women: A Report From the REVIVAL Registry.
JACC Heart Fail
; 7(7): 602-611, 2019 07.
Article
em En
| MEDLINE
| ID: mdl-31078480
ABSTRACT
OBJECTIVES:
This study sought to explore clinical characteristics and outcomes in women and men with ambulatory advanced heart failure (HF).BACKGROUND:
Women have been underrepresented in studies of advanced HF and have an increased mortality on the transplant waiting list and early after mechanical circulatory support (MCS). An increased understanding of the differential burden of HF between women and men is required to inform the use of mechanical circulatory support in ambulatory advanced HF patients.METHODS:
REVIVAL (Registry Evaluation for Vital Information on Ventricular Assist Devices in Ambulatory Life) is a prospective, observational study of 400 outpatients with chronic systolic HF, New York Heart Association functional class II to IV, and 1 additional high-risk feature. Clinical characteristics, quality of life, and functional capacity were compared between women and men, as was a primary composite endpoint of death, durable MCS, or urgent heart transplantation at 1 year.RESULTS:
REVIVAL enrolled 99 women (25% of the cohort) who had similar age, ejection fraction, INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) profiles, medication use, and willingness to consider MCS as the men enrolled; however, women reported significantly greater limitations in quality of life with respect to physical limitation, reduced 6-min walk distance, and more frequent symptoms of depression. Nevertheless, 1-year combined risk of death, durable MCS, or urgent transplantation did not differ between women and men (24% vs. 22%; p = 0.94).CONCLUSIONS:
This study represents the largest report to date of women with ambulatory advanced HF receiving contemporary therapies. Systematic elicitation of patient-reported outcome measures uncovered an added burden of HF in women and may be an appropriate target of augmented support and intervention.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
/
Atividades Cotidianas
/
Insuficiência Cardíaca Sistólica
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Aspecto:
Patient_preference
Limite:
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
JACC Heart Fail
Ano de publicação:
2019
Tipo de documento:
Article