Impact of Coronary Artery Disease in Women With Newly Diagnosed Heart Failure and Reduced Ejection Fraction

Roni Ranghoej Nielsen; Nanna Anker; Nina Stødkilde-Jørgensen; Pernille Gro Thrane; Malene Kærslund Hansen; Kasper Pryds; Martin Bødtker Mortensen; Kevin Kris Warnakula Olesen; Michael Maeng

doi:10.1016/j.jchf.2023.07.013

Impact of Coronary Artery Disease in Women With Newly Diagnosed Heart Failure and Reduced Ejection Fraction

Roni Ranghoej Nielsen, Nanna Anker, Nina Stødkilde-Jørgensen, Pernille Gro Thrane, Malene Kærslund Hansen, Kasper Pryds, Martin Bødtker Mortensen, Kevin Kris Warnakula Olesen, Michael Maeng

Department of Clinical Medicine - The Department of Cardiological Medicine B

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Background: The representation of women in heart failure studies has been inadequate, resulting in a knowledge gap regarding the prognostic impact of coronary artery disease (CAD) on all-cause mortality in women with newly diagnosed heart failure and reduced ejection fraction (HFrEF). Objectives: This study aims to assess the prognostic impact of CAD in women with HFrEF. Methods: Using the Western Denmark Heart Registry, the authors identified 891 women and 2,403 men referred for first-time coronary angiography because of HFrEF. The authors stratified for presence of CAD, estimated 10-year all-cause mortality, and calculated crude and adjusted HRs (aHRs) with 95% CIs. Results: The 10-year mortality was 60% in women with CAD and 27% in women without CAD; for men, the corresponding numbers were 54% and 36%. When adjusted for comorbidities, women without CAD had a lower relative 10-year mortality than men without CAD (aHR: 0.73; 95% CI: 0.58-0.91), whereas women with CAD had similar relative mortality as men with CAD (aHR: 1.00; 95% CI: 0.81-1.24) (P _interaction = 0.037). Assessed by the number of coronary vessels with significant stenosis, CAD extent was associated with mortality for both women (P < 0.01) and men (P < 0.01). However, compared to those without CAD, the aHR was higher for women with any degree of CAD (aHR ranging from 1.61 [95% CI: 1.09-2.38] for diffuse CAD to 2.01 [95% CI: 1.19-3.40] for 3-vessel disease) than for men with 3-vessel disease (aHR: 1.51; 95% CI: 1.19-1.91). Conclusions: In patients with newly diagnosed HFrEF, the presence and extent of CAD has significantly greater prognostic impact among women than among men.

Original language	English
Journal	JACC: Heart Failure
Volume	11
Issue	12
Pages (from-to)	1653-1663
Number of pages	11
ISSN	2213-1779
DOIs	https://doi.org/10.1016/j.jchf.2023.07.013
Publication status	Published - Dec 2023

Keywords

coronary artery disease
epidemiology
heart failure and reduced ejection fraction
women
Stroke Volume
Coronary Angiography
Prognosis
Humans
Heart Failure/complications
Female
Male
Coronary Artery Disease/complications

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10.1016/j.jchf.2023.07.013

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@article{10f8d4c7645b4aec8e15a05528f7fa9f,

title = "Impact of Coronary Artery Disease in Women With Newly Diagnosed Heart Failure and Reduced Ejection Fraction",

abstract = "Background: The representation of women in heart failure studies has been inadequate, resulting in a knowledge gap regarding the prognostic impact of coronary artery disease (CAD) on all-cause mortality in women with newly diagnosed heart failure and reduced ejection fraction (HFrEF). Objectives: This study aims to assess the prognostic impact of CAD in women with HFrEF. Methods: Using the Western Denmark Heart Registry, the authors identified 891 women and 2,403 men referred for first-time coronary angiography because of HFrEF. The authors stratified for presence of CAD, estimated 10-year all-cause mortality, and calculated crude and adjusted HRs (aHRs) with 95% CIs. Results: The 10-year mortality was 60% in women with CAD and 27% in women without CAD; for men, the corresponding numbers were 54% and 36%. When adjusted for comorbidities, women without CAD had a lower relative 10-year mortality than men without CAD (aHR: 0.73; 95% CI: 0.58-0.91), whereas women with CAD had similar relative mortality as men with CAD (aHR: 1.00; 95% CI: 0.81-1.24) (P interaction = 0.037). Assessed by the number of coronary vessels with significant stenosis, CAD extent was associated with mortality for both women (P < 0.01) and men (P < 0.01). However, compared to those without CAD, the aHR was higher for women with any degree of CAD (aHR ranging from 1.61 [95% CI: 1.09-2.38] for diffuse CAD to 2.01 [95% CI: 1.19-3.40] for 3-vessel disease) than for men with 3-vessel disease (aHR: 1.51; 95% CI: 1.19-1.91). Conclusions: In patients with newly diagnosed HFrEF, the presence and extent of CAD has significantly greater prognostic impact among women than among men.",

keywords = "coronary artery disease, epidemiology, heart failure and reduced ejection fraction, women, Stroke Volume, Coronary Angiography, Prognosis, Humans, Heart Failure/complications, Female, Male, Coronary Artery Disease/complications",

author = "Nielsen, {Roni Ranghoej} and Nanna Anker and Nina St{\o}dkilde-J{\o}rgensen and Thrane, {Pernille Gro} and Hansen, {Malene K{\ae}rslund} and Kasper Pryds and Mortensen, {Martin B{\o}dtker} and Olesen, {Kevin Kris Warnakula} and Michael Maeng",

year = "2023",

month = dec,

doi = "10.1016/j.jchf.2023.07.013",

language = "English",

volume = "11",

pages = "1653--1663",

journal = "JACC: Heart Failure",

issn = "2213-1779",

publisher = "Elsevier",

number = "12",

}

Impact of Coronary Artery Disease in Women With Newly Diagnosed Heart Failure and Reduced Ejection Fraction. / Nielsen, Roni Ranghoej; Anker, Nanna; Stødkilde-Jørgensen, Nina et al.
In: JACC: Heart Failure, Vol. 11, No. 12, 12.2023, p. 1653-1663.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Impact of Coronary Artery Disease in Women With Newly Diagnosed Heart Failure and Reduced Ejection Fraction

AU - Nielsen, Roni Ranghoej

AU - Anker, Nanna

AU - Stødkilde-Jørgensen, Nina

AU - Thrane, Pernille Gro

AU - Hansen, Malene Kærslund

AU - Pryds, Kasper

AU - Mortensen, Martin Bødtker

AU - Olesen, Kevin Kris Warnakula

AU - Maeng, Michael

PY - 2023/12

Y1 - 2023/12

N2 - Background: The representation of women in heart failure studies has been inadequate, resulting in a knowledge gap regarding the prognostic impact of coronary artery disease (CAD) on all-cause mortality in women with newly diagnosed heart failure and reduced ejection fraction (HFrEF). Objectives: This study aims to assess the prognostic impact of CAD in women with HFrEF. Methods: Using the Western Denmark Heart Registry, the authors identified 891 women and 2,403 men referred for first-time coronary angiography because of HFrEF. The authors stratified for presence of CAD, estimated 10-year all-cause mortality, and calculated crude and adjusted HRs (aHRs) with 95% CIs. Results: The 10-year mortality was 60% in women with CAD and 27% in women without CAD; for men, the corresponding numbers were 54% and 36%. When adjusted for comorbidities, women without CAD had a lower relative 10-year mortality than men without CAD (aHR: 0.73; 95% CI: 0.58-0.91), whereas women with CAD had similar relative mortality as men with CAD (aHR: 1.00; 95% CI: 0.81-1.24) (P interaction = 0.037). Assessed by the number of coronary vessels with significant stenosis, CAD extent was associated with mortality for both women (P < 0.01) and men (P < 0.01). However, compared to those without CAD, the aHR was higher for women with any degree of CAD (aHR ranging from 1.61 [95% CI: 1.09-2.38] for diffuse CAD to 2.01 [95% CI: 1.19-3.40] for 3-vessel disease) than for men with 3-vessel disease (aHR: 1.51; 95% CI: 1.19-1.91). Conclusions: In patients with newly diagnosed HFrEF, the presence and extent of CAD has significantly greater prognostic impact among women than among men.

AB - Background: The representation of women in heart failure studies has been inadequate, resulting in a knowledge gap regarding the prognostic impact of coronary artery disease (CAD) on all-cause mortality in women with newly diagnosed heart failure and reduced ejection fraction (HFrEF). Objectives: This study aims to assess the prognostic impact of CAD in women with HFrEF. Methods: Using the Western Denmark Heart Registry, the authors identified 891 women and 2,403 men referred for first-time coronary angiography because of HFrEF. The authors stratified for presence of CAD, estimated 10-year all-cause mortality, and calculated crude and adjusted HRs (aHRs) with 95% CIs. Results: The 10-year mortality was 60% in women with CAD and 27% in women without CAD; for men, the corresponding numbers were 54% and 36%. When adjusted for comorbidities, women without CAD had a lower relative 10-year mortality than men without CAD (aHR: 0.73; 95% CI: 0.58-0.91), whereas women with CAD had similar relative mortality as men with CAD (aHR: 1.00; 95% CI: 0.81-1.24) (P interaction = 0.037). Assessed by the number of coronary vessels with significant stenosis, CAD extent was associated with mortality for both women (P < 0.01) and men (P < 0.01). However, compared to those without CAD, the aHR was higher for women with any degree of CAD (aHR ranging from 1.61 [95% CI: 1.09-2.38] for diffuse CAD to 2.01 [95% CI: 1.19-3.40] for 3-vessel disease) than for men with 3-vessel disease (aHR: 1.51; 95% CI: 1.19-1.91). Conclusions: In patients with newly diagnosed HFrEF, the presence and extent of CAD has significantly greater prognostic impact among women than among men.

KW - coronary artery disease

KW - epidemiology

KW - heart failure and reduced ejection fraction

KW - women

KW - Stroke Volume

KW - Coronary Angiography

KW - Prognosis

KW - Humans

KW - Heart Failure/complications

KW - Female

KW - Male

KW - Coronary Artery Disease/complications

U2 - 10.1016/j.jchf.2023.07.013

DO - 10.1016/j.jchf.2023.07.013

M3 - Journal article

C2 - 37632494

SN - 2213-1779

VL - 11

SP - 1653

EP - 1663

JO - JACC: Heart Failure

JF - JACC: Heart Failure

IS - 12

ER -

Impact of Coronary Artery Disease in Women With Newly Diagnosed Heart Failure and Reduced Ejection Fraction

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Keywords

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