American researchers found that women who suffer from heart failure and are candidates for a heart transplant have a higher risk of death within 1 year of waiting in line.

After adding other factors, such as age, race, ethnicity, blood type, body mass index, presence of diabetes, glomerular filtration rate, pulmonary artery wedge pressure (PWP), support with ECMO or an intra-aortic balloon pump, to the analysis, women still had.

The reasons for exclusion could be the death of the patient or the occurrence of serious complications (95% CI 1.01-1.20; p\u003d0.026).

Such data were released at a meeting of the Heart Failure Society of America by Dr. Alanna Morris and her colleagues from the Emory School of Medicine (Atlanta).

However, when Dr. Morris and colleagues added the use of implantable cardioverter defibrillators (ICD) and ventricular assist devices (VAD) to the analysis, this difference lost its statistical significance (OR 1.06; 95% CI 0.97-1.15, p\u003d0.20).

“Higher mortality in women while waiting for a heart transplant may be due to the different frequency of ICD and VAD use in different sexes. This suggests that women need more aggressive supportive care to address the 10 percent difference we found in mortality and morbidity,” concluded Dr. Morris..

A new set of clinical guidelines published this year by the International Heart and Lung Transplant Society aims to improve the selection of patients who are recommended to use ventricular assistive devices..

This guideline emphasizes that heart transplantation should be considered for all patients recommended for VAD use, as " The authors of the guidelines also note that there is a trend towards identifying candidates for VAD at an earlier stage of disease, giving them a chance at a better quality of life..

“Identifying patients who need mechanical circulatory support is a complex process that requires experienced and highly trained heart failure professionals,” writes Dr..

Dr. Morris and colleagues noted that data from local heart failure studies suggest better survival in women compared to men.. However, little is known about the gender differences in survival of patients with end-stage heart failure who are placed on the transplant waiting list..

Scientists reviewed data from the Organ Procurement and Transplantation database from 2000 to 2012 and identified 26,872 patients over the age of 18 (23% women) who were on the waiting list for a heart transplant for the first time..

Women were less likely to have an implantable cardioverter-defibrillator (55% vs 64%, P\u003c0.001) and a ventricular assist device (24% vs 30%, P\u003c0.001).

Compared to men, women:.

• Were younger: mean age 52 vs 56 (P\u003c0.001).

• Less likely to have diabetes: 21% vs 27% (P\u003c0.001).

• Less likely to have normal glomerular filtration rate: 49% vs 53% (P\u003c0.001).

• Had a lower pulmonary artery wedge pressure: 20 vs. 21 mm. rt. st. (P\u003c0.001).

• Spent less time on the transplant list: 67 vs 84 days (P\u003c0.001).

In addition, it was found that some other groups of patients did not achieve better outcomes after transplantation..

Dr. Morris has previously reported that heart transplants in African Americans do not improve outcomes as expected - this may be due to the immunological characteristics of the race..

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