Sex differences in patients with advanced heart failure: an analysis of the HELP-HF registry
Year: 2026
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Sex differences are reported in patients with heart failure (HF), but gaps remain in clinical practice and evidence, in particular, in those with advanced HF. METHODS: The HELP-HF registry enrolled consecutive patients with HF and at least one high-risk 'I NEED HELP' marker, evaluated at four Italian centres between 1 January 2020 and 30 November 2021. Patients' characteristics and outcomes were compared in men vs women. The primary endpoint was the composite of all-cause mortality or first HF hospitalization. RESULTS: A total of 1149 patients were included (mean age 75.1 ± 11.5 years, median left ventricular ejection fraction 35%). Among them, 773 patients (67.3%) were males. Males were younger, had more cardiovascular diseases and a lower left ventricular ejection fraction (32%, [interquartile range 25-45] vs 45% [interquartile range 30-55]), while females showed a higher prevalence of non-cardiac conditions, neurocognitive and depressive disorders. The 1-year rate of the primary composite endpoint was 43.2% in males and 43.1% in females (log-rank P = .857). Multivariable analysis confirmed the lack of a significant impact of sex on the primary endpoint (adjusted hazard ratio 1.03, 95% confidence interval 0.85-1.27, P = .740). No significant differences were also observed in men vs women for the individual endpoints. CONCLUSIONS: In our registry enrolling patients with markers of advanced HF, despite differences in clinical and echocardiographic characteristics, no sex-related differences in clinical outcomes were observed.
Source: ESC Heart Failure
Authors: Mauro Riccardi, Chiara Tedino, Mauro Chiarito, Davide Stolfo, Luca Baldetti, Daniela Tomasoni, Riccardo Maria Inciardi, Marianna Adamo, Alessandro Villaschi, Ferdinando Loiacono, Marta Maccallini, Gaia Gasparini, Stefano Contessi, Daniele Cocianni, Maria Perotto, Giuseppe Barone, Marco Merlo, Alberto Maria Cappelletti, Gianfranco Sinagra, Daniela Pini, Marco Metra, Matteo Pagnesi, Carlo Mario Lombardi
Institutions: Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Istituti Ospitalieri di Cremona, University of Brescia, Humanitas University, IRCCS Humanitas Research Hospital, Karolinska Institutet, Stockholm South General Hospital, Azienda sanitaria universitaria Friuli Centrale, IRCCS Ospedale San Raffaele, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Trieste, Azienda sanitaria universitaria Giuliano Isontina, Azienda Ospedaliera San Gerardo
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,850
OpenAlex ID: W7129150350