Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

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\ua0 64 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\ua0=\ua00.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P\ua075 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 6445%

Calixarene/azolium cyclophane hybrids: Synthesis, structure and conformations

© Springer Science+Business Media Dordrecht 2015.The synthesis, structure, and conformational behaviour of three imidazolium cyclophanes that incorporate one or two 4-tert-butylphenol or 4-tert-butylanisole groups as meta-disubstituted linkers in the macrocycle is described. The cyclophanes containing anisole moieties adopt a cone conformation in the solid state, which, in solution, is not labile on the NMR timescale. The cyclophanes containing one or two phenol moieties adopt conformations other than the cone in the solid state and are labile in solution on the NMR timescale. The phenol cyclophanes are readily deprotonated, and structural and conformational studies for a variety of the associated cyclophanes are also reported