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已发表论文
射血分数降低的心力衰竭合并贫血及高尿酸血症患者的性别差异：一项回顾性病例研究
Authors Liu Z , Yan B, Huang R, Zhou Y, Pan X
Received 6 June 2025
Accepted for publication 18 September 2025
Published 22 September 2025 Volume 2025:18 Pages 5755—5763
DOI https://doi.org/10.2147/IJGM.S536026
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Redoy Ranjan
Zhengjiang Liu,1,* Bixia Yan,2,* Ronghua Huang,1 Yi Zhou,1 Xingshou Pan1
1Department of Cardiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Baise, Guangxi, 533000, People’s Republic of China; 2Department of Nephrology, Affiliated Hengyang Hospital of Hunan Normal University, Hengyang, Hunan, 421001, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhengjiang Liu, Department of Cardiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Baise, Guangxi, 533000, People’s Republic of China, Email j29542006@vip.tom.com
Objective: Heart failure with reduced ejection fraction (HFrEF) is associated with high mortality and morbidity. This study aimed to investigate sex differences in clinical characteristics, ventricular remodeling, cardiovascular risk factors, and prognosis among patients with HFrEF complicated by anemia and hyperuricemia.
Subjects and Methods: We analyzed data from patients with HFrEF admitted to the Affiliated Hospital of Youjiang Medical University for Nationalities between January 1, 2018, and September 1, 2022. A total of 185 patients with HFrEF, anemia, and hyperuricemia (HU) were included. Laboratory and echocardiographic parameters were examined, and Cox regression analysis was used to identify prognostic risk factors. Clinical characteristics and prognostic factors were compared between sexes.
Results: Female patients had lower body weight, smaller body size, more severe anemia, and fewer ischemic causes of ventricular remodeling compared with male patients. Male patients had a higher prevalence of smoking and renal insufficiency. Serum uric acid predicted lower extremity venous thrombosis (area under the curve = 0.736). During a median follow-up of 21.78 months, no significant sex difference in cardiovascular events was observed. However, multivariate Cox proportional hazards analysis demonstrated sex-specific prognostic factors. The independent risk factors in males were body weight (HR = 1.035, 95% CI: 1.016– 1.054, P = 0.001), total protein (HR = 0.965, 95% CI: 0.934– 0.997, P = 0.031), albumin/globulin ratio (HR = 2.024, 95% CI: 1.093– 3.749, P = 0.025), and atrial fibrillation (HR = 0.399, 95% CI: 0.254– 0.627, P = 0.001). Independent risk factor in females was MCHC (HR = 1.037, 95% CI: 1.011– 1.064, P = 0.005).
Conclusion: In patients with HFrEF, anemia, and HU, males and females exhibited distinct clinical characteristics and cardiovascular risk factors, despite having similar survival outcomes. These findings underscore the importance of addressing sex-specific risk profiles in the clinical management of HFrEF.
Keywords: chronic heart failure, anemia, serum uric acid, ventricular remodeling, sex differences
1Department of Cardiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Baise, Guangxi, 533000, People’s Republic of China; 2Department of Nephrology, Affiliated Hengyang Hospital of Hunan Normal University, Hengyang, Hunan, 421001, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhengjiang Liu, Department of Cardiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Baise, Guangxi, 533000, People’s Republic of China, Email j29542006@vip.tom.com
Objective: Heart failure with reduced ejection fraction (HFrEF) is associated with high mortality and morbidity. This study aimed to investigate sex differences in clinical characteristics, ventricular remodeling, cardiovascular risk factors, and prognosis among patients with HFrEF complicated by anemia and hyperuricemia.
Subjects and Methods: We analyzed data from patients with HFrEF admitted to the Affiliated Hospital of Youjiang Medical University for Nationalities between January 1, 2018, and September 1, 2022. A total of 185 patients with HFrEF, anemia, and hyperuricemia (HU) were included. Laboratory and echocardiographic parameters were examined, and Cox regression analysis was used to identify prognostic risk factors. Clinical characteristics and prognostic factors were compared between sexes.
Results: Female patients had lower body weight, smaller body size, more severe anemia, and fewer ischemic causes of ventricular remodeling compared with male patients. Male patients had a higher prevalence of smoking and renal insufficiency. Serum uric acid predicted lower extremity venous thrombosis (area under the curve = 0.736). During a median follow-up of 21.78 months, no significant sex difference in cardiovascular events was observed. However, multivariate Cox proportional hazards analysis demonstrated sex-specific prognostic factors. The independent risk factors in males were body weight (HR = 1.035, 95% CI: 1.016– 1.054, P = 0.001), total protein (HR = 0.965, 95% CI: 0.934– 0.997, P = 0.031), albumin/globulin ratio (HR = 2.024, 95% CI: 1.093– 3.749, P = 0.025), and atrial fibrillation (HR = 0.399, 95% CI: 0.254– 0.627, P = 0.001). Independent risk factor in females was MCHC (HR = 1.037, 95% CI: 1.011– 1.064, P = 0.005).
Conclusion: In patients with HFrEF, anemia, and HU, males and females exhibited distinct clinical characteristics and cardiovascular risk factors, despite having similar survival outcomes. These findings underscore the importance of addressing sex-specific risk profiles in the clinical management of HFrEF.
Keywords: chronic heart failure, anemia, serum uric acid, ventricular remodeling, sex differences