Prospective cohort study of characteristics and sex differences in elderly patients with degenerative valvular disease

Objectives We aimed to describe the characteristics and to compare the sex differences in the clinical features and prognosis of Chinese elderly patients with senile degenerative valvular heart disease (VHD).Design This study was a nationwide, multicentre, prospective cohort study.Setting Participan...

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Main Authors: Haiyan Xu, Yongjian Wu, Xiling Qi, Qingrong Liu, Yunqing Ye
Format: Article
Language:English
Published: BMJ Publishing Group 2022-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/8/e060882.full
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author Haiyan Xu
Yongjian Wu
Xiling Qi
Qingrong Liu
Yunqing Ye
author_facet Haiyan Xu
Yongjian Wu
Xiling Qi
Qingrong Liu
Yunqing Ye
author_sort Haiyan Xu
collection DOAJ
description Objectives We aimed to describe the characteristics and to compare the sex differences in the clinical features and prognosis of Chinese elderly patients with senile degenerative valvular heart disease (VHD).Design This study was a nationwide, multicentre, prospective cohort study.Setting Participants were enrolled consecutively from 69 hospitals nationwide in China from September to December 2016.Participants A total of 2728 patients aged ≥60 years old with an aetiological diagnosis of moderate to severe degenerative VHD as defined by echocardiography were recruited.Main outcome measures The baseline data and 1-year follow-up data were collected, and disease distribution, clinical features, treatment and prognosis were compared between different sex groups.Results Aortic disease was more common in men, and mitral disease was more common in women. Male patients were more likely to have smoking, coronary heart disease, cardiomyopathy, chronic obstructive pulmonary disease and coronary artery bypass grafting histories, while female patients had more hypertension and atrial fibrillation. The average age and left ventricular ejection fraction were significantly lower in men than in women (p<0.001), while the intervention rate (p=0.026) and total hospitalisation cost (p=0.016) of male patients were higher than those of female patients. There were no significant differences in perioperative complications, in-hospital outcomes or short and intermediate prognoses between the two groups.Conclusions Currently, the intervention rate of elderly patients with VHD is still not ideal, with dominant factor—patient rejection. Heart failure was the critical reason for rehospitalisation. There were some differences between men and women in the distribution, severity, clinical characteristics and interventions in senile degenerative valvular disease.
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spelling doaj.art-43bd7049ab4e48bdbfd9b49e3f707af42022-12-22T02:52:22ZengBMJ Publishing GroupBMJ Open2044-60552022-08-0112810.1136/bmjopen-2022-060882Prospective cohort study of characteristics and sex differences in elderly patients with degenerative valvular diseaseHaiyan Xu0Yongjian Wu1Xiling Qi2Qingrong Liu3Yunqing Ye41 Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Peking Union Medical College, Beijing, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Cardiology, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital, Xicheng, Beijing, ChinaDepartment of Cardiology, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital, Xicheng, Beijing, ChinaDepartment of Cardiology, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital, Xicheng, Beijing, ChinaObjectives We aimed to describe the characteristics and to compare the sex differences in the clinical features and prognosis of Chinese elderly patients with senile degenerative valvular heart disease (VHD).Design This study was a nationwide, multicentre, prospective cohort study.Setting Participants were enrolled consecutively from 69 hospitals nationwide in China from September to December 2016.Participants A total of 2728 patients aged ≥60 years old with an aetiological diagnosis of moderate to severe degenerative VHD as defined by echocardiography were recruited.Main outcome measures The baseline data and 1-year follow-up data were collected, and disease distribution, clinical features, treatment and prognosis were compared between different sex groups.Results Aortic disease was more common in men, and mitral disease was more common in women. Male patients were more likely to have smoking, coronary heart disease, cardiomyopathy, chronic obstructive pulmonary disease and coronary artery bypass grafting histories, while female patients had more hypertension and atrial fibrillation. The average age and left ventricular ejection fraction were significantly lower in men than in women (p<0.001), while the intervention rate (p=0.026) and total hospitalisation cost (p=0.016) of male patients were higher than those of female patients. There were no significant differences in perioperative complications, in-hospital outcomes or short and intermediate prognoses between the two groups.Conclusions Currently, the intervention rate of elderly patients with VHD is still not ideal, with dominant factor—patient rejection. Heart failure was the critical reason for rehospitalisation. There were some differences between men and women in the distribution, severity, clinical characteristics and interventions in senile degenerative valvular disease.https://bmjopen.bmj.com/content/12/8/e060882.full
spellingShingle Haiyan Xu
Yongjian Wu
Xiling Qi
Qingrong Liu
Yunqing Ye
Prospective cohort study of characteristics and sex differences in elderly patients with degenerative valvular disease
BMJ Open
title Prospective cohort study of characteristics and sex differences in elderly patients with degenerative valvular disease
title_full Prospective cohort study of characteristics and sex differences in elderly patients with degenerative valvular disease
title_fullStr Prospective cohort study of characteristics and sex differences in elderly patients with degenerative valvular disease
title_full_unstemmed Prospective cohort study of characteristics and sex differences in elderly patients with degenerative valvular disease
title_short Prospective cohort study of characteristics and sex differences in elderly patients with degenerative valvular disease
title_sort prospective cohort study of characteristics and sex differences in elderly patients with degenerative valvular disease
url https://bmjopen.bmj.com/content/12/8/e060882.full
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