Melbourne Medical School Collected Works - Research Publications

Permanent URI for this collection

http://hdl.handle.net/11343/220

Filters

2019 1
1
Reset filters

Settings
Statistics
Citations
Start date: 2010 × Author: Marwick, Thomas × Author: Costello, Benedict × End date: 2019 ×

Search Results

Now showing 1 - 1 of 1
  • Item
    Thumbnail Image
    Impact of sex, socio-economic status, and remoteness on therapy and survival in heart failure
    Gutman, SJ ; Costello, BT ; Papapostolou, S ; Iles, L ; Ja, J ; Hare, JL ; Ellims, A ; Marwick, TH ; Taylor, AJ (WILEY PERIODICALS, INC, 2019-10)
    AIMS: This study aims to determine if traditional markers of disadvantage [female sex, low socio-economic status (SES), and remoteness] are associated with lower prescription of evidence-based therapy and higher mortality among patients with moderate-severe heart failure with reduced ejection fraction. METHODS AND RESULTS: We recruited 452 consecutive class II-III heart failure with reduced ejection fraction patients. Baseline clinical data were recorded prospectively. The primary outcome was the association of female sex on overall survival. Secondary outcomes included association between evidence-based therapy delivery and sex and association of SES and remoteness on heart failure therapy and survival. The Australian Bureau of Statistics generated all indices. Median follow-up was 37.9 months. One hundred and nine patients (24.3%) were women. There was no difference in overall survival based on sex (hazard ratio = 1.19, 95% confidence interval: 0.74-1.92, 0.48). There was no difference in prescription of beta-blockers [χ2 (1) = 0.91, 0.66], angiotensin-converting enzyme inhibitors [χ2 (1) = 0.001, 0.97], nor aldosterone antagonists [χ2 (1) = 2.71, 0.10]. There was no difference in rates of primary prevention implantable cardioverter-defibrillator implantation in men compared with women [χ2 (1) = 0.35, 0.56]. Neither higher SES nor inner city residence conferred an overall survival benefit. CONCLUSIONS: In this Australian cohort of heart failure patients, delivery of care and likelihood of death are comparable between the sexes, SES groups, and rural vs. city residents.