AIMS This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. METHODS AND RESULTS Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P ≤ 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P = 0.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P < 0.001) and there were no differences in causes of death. All-cause mortality and all-cause hospitalization increased with greater age in both sexes. Sex was not an independent predictor of 1-year all-cause mortality (restricted to patients with LVEF ≤45%). Mortality risk was significantly lower in patients of younger age, compared to patients aged >75 years. CONCLUSIONS There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF ≤45%.

中文翻译：

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慢性心力衰竭的治疗和结局中与性别和年龄相关的差异：ESC HFA EORP心力衰竭长期注册中心对患者的分析。

目的本研究旨在评估慢性心力衰竭（HF）患者的年龄和性别相关管理差异以及全因死亡率和住院治疗的1年风险。方法和结果纳入欧洲心脏病学会心力衰竭长期注册中心的16 354例患者中，对9 428例慢性HF患者进行了分析[中位年龄：66岁；年龄：66岁]。28.5％的女性；平均左心室射血分数（LVEF）37％]。指导性药物治疗（GDMT）的使用率很高（血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂，β受体阻滞剂和盐皮质激素受体拮抗剂：分别为85.7％，88.7％和58.8％）。女性的粗GDMT利用率低于男性（所有差异：P≤0.001），并且在基线和1年随访中，随着性别的增长，GDMT的使用率均降低。性别不是GDMT处方的独立预测因素；但是，年龄大于75岁是GDMT使用不足的重要预测因素。女性全因死亡率低于男性（7.1％vs. 8.7％； P = 0.015），全因住院率（21.9％vs. 27.3％； P <0.001）也没有。死亡原因的差异。随着年龄的增长，男女双方的全因死亡率和全因住院率均增加。性别不是1年全因死亡率的独立预测因子（仅限于LVEF≤45％的患者）。与年龄大于75岁的患者相比，年龄较小的患者的死亡风险显着降低。结论随着年龄的增长，两性使用GDMT的人数有所减少。性别不是GDMT或不良结局的独立预测因素。但是，年龄>