Predictors of 24-month survival in patients with chronic heart failure and reduced left ventricular ejection fraction depending on gender
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Abstract
The aim – to compare survival rates and predictors of the onset of lethal outcome in men and women with chronic heart failure (CHF) with reduced left ventricular ejection fraction (LVEF) during 24-months follow-up.
Material and methods. 356 patients with ischemic CHF (NYHA II–ІV) and LVEF < 40 % were examined. Cumulative survival was calculated by Kaplan – Meier method. Comparison of survival in groups was performed by Mantel – Cox test. Predictors of survival were determined by multiple logistic regression. Cut-off values of clinical variables associated with non – survival during 24 months of follow-up were determined.
Results. Analysis of survival in patients with CHF and reduced LVEF showed that cumulative survival at the end of 24 manth of follow-up was not significantly different (P=0.092), 68 % in men and 72 % in women. Factors associated with poor prognosis varied significantly depending on gender. We determined indicators associated with poor survival by cluster analysis. In men these were: left ventricle free wall thickness < 0,75 сm, ureic acid > 627 mkmol/L, LVESV
index > 110 cm/m2, LVEF < 25 %, LVEDV > 340 mL (ОR 6.8–5.7). In women, these were glucose level > 11,4 l/L, LVESV > 287 mL, LVEDV > 302 mL, LVESD > 6,5 cm, IVS thickness less than 0,7 cm, LVEDV index > 176 cm/m2
(ОR 16.2–11.2).
Conclusion. Survival of men and women with CHF and reduced LVEF during 24-month of follow-up not significantly different, while predictors of lethal outcome are different.
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