Age and sex are both factors in the treatment and outcomes of patients with heart failure (HF). Current research shows that women and older patients are under-represented in HF clinical trials, and as a result, guideline recommendations are largely based on data from men.
Published in JACC: Heart Failure, this secondary analysis of the VICTORIA trial examined the associations of age and sex with clinical characteristics, background therapies, outcomes, and response to vericiguat (a drug used to reduce the risk of death and hospitalization in people with chronic HF) in 5,050 VICTORIA patients with HF and reduced ejection fraction (a condition in which the heart is unable to pump out blood effectively). Among this patient population, 31% were 75 years of age or older, while 24% were women.
The researchers compared the clinical characteristics of patients across three age groups (<65, 65 to <75, and ≤75 years) and sex. The treatment effect of vericiguat was measured by age and sex on the primary outcomes of the VICTORIA study (time to first HF hospitalization or cardiovascular death) using the Cox proportional hazards regression, a method that evaluates the impact of several variables on survival rate.
The researchers found that, although older women received less intense background HF therapy in comparison to men, their prognosis was slightly better. Additionally, vericiguat was shown to consistently reduce the risk of HF hospitalization and cardiovascular death across the broad spectrum of VICTORIA patients, demonstrating that the benefit of vericiguat is independent of both age or sex.
“More efforts are required to include older women in such studies, as is vigilance to ensure the benefits of evidence-based therapies – including devices – for heart failure given its impact on mortality and morbidity,” says study co-author Dr. Paul Armstrong.
This research, conducted on behalf of the VICTORIA study group, was led by Dr. Carolyn Lam (National Heart Centre Singapore and Duke-National University of Singapore), in conjunction with CVC co-authors Dr. Paul Armstrong, Dr. Cynthia Westerhout, and Yinggan (Gray) Zheng, and editorially supported by Lisa Soulard, whose touches in the central figure were a great addition.
