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In conclusion, the association between inflammation as indicated by tumor necrosis factor-alpha and event-free survival differs between men and women with HF. These findings suggest a sex-related difference in the effect of inflammation on prognosis in patients with HF.
A total of 2,039 patients without CHF were enrolled from April 2011 through October 2014 and followed for a median of 26 months. They were stratified into tertiles by tumor necrosis factor-alpha concentration: low (3.2 pg/mL). In men, event-free survival was not associated with tumor necrosis factor-alpha (log-rank P = 0.17). In women, event-free survival was associated with the severity of inflammation as indicated by tumor necrosis factor-alpha (log-rank P < 0.001). In women, Cox regression analysis showed that high tumor necrosis factor-alpha was associated with poor event-free survival (hazard ratio, 1.91; 95% confidence interval, 1.24-2.96; P = 0.004). Low BNP was also associated with poor event-free survival in women (hazard ratio, 1.91; 95% confidence interval, 1.26-2.92; P = 0.003).
Echocardiography and B-type natriuretic peptide (BNP) measurement were performed at baseline, and Cox proportional hazards models were constructed to examine whether the association between inflammation as indicated by tumor necrosis factor- and event-free survival differs between men and women with HF after controlling for demographic and clinical variables.
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