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Ejection fraction and mortality: A nationwide register‐based cohort study of 499,153 women and men

European Journal of Heart Failure Dec 11, 2020

Stewart S, Playford D, Scalia GM, et al. - Researchers used a large cohort of patients in Australia, to determine the gender-based risk of death across the spectrum of left ventricular ejection fraction (LVEF). They found that an LVEF < 40% was related to the highest crude cardiovascular‐related and all‐cause death at 5 years (∼20–30% and ∼ 40–50%, respectively). Thereafter, in both genders, actual cardiovascular‐related and all‐cause death at 5 years was shown to steeply improve to a nadir LVEF of 65.0–69.9% (reference group). Below this LVEF level, the adjusted hazard ratio (HR) for cardiovascular‐associated death for a LVEF of 55.0–59.9% was estimated to be 1.36 and 1.21 in women and men, respectively. An LVEF of 60.0–64.9% in women was also found to be related to a HR 1.33 for cardiovascular‐related mortality. Findings revealed the presence of clinically relevant gender‐based disparities in the distribution and mortality related to an LVEF < 65.0–69.9%, in patients inquired for suspected or established cardiovascular disease. Particularly, a greater risk of death at higher LVEF levels was suggested in women.

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