Are There Gender Differences in the Benefits of Multidisciplinary Care in Patients with Heart Failure? Results from the UMIPIC Program

<b>Background/Objectives</b>: Heart failure (HF) is a leading cause of hospitalization in older adults, with significant sex differences in presentation, treatment, and outcomes. Transitional care models may benefit women more, yet they often receive less follow-up. This study assessed whether the clinical impact of the UMIPIC multidisciplinary HF management program differs by sex. <b>Methods:</b> This prospective, multicenter, observational cohort study included HF patients enrolled in the UMIPIC program or followed through conventional care in the RICA registry. Outcomes (30-day and one-year mortality and readmissions) were compared between groups, stratified by sex. Multivariate Cox models adjusted for age, HF phenotype, comorbidities, and baseline therapy. <b>Results:</b> A total of 5644 HF patients were included, with 2034 (36%) managed in UMIPIC and 3610 (64%) receiving conventional care. Women represented 55% of UMIPIC patients and were older, with higher prevalence of hypertension, anemia, and HF with preserved ejection fraction (HFpEF) compared to conventional care. At 30 days, women in UMIPIC had lower all-cause mortality (4.0% vs. 8.0%), cardiovascular mortality (2.0% vs. 6.0%), and readmissions (9.0% vs. 18.0%; all <i>p</i> < 0.01); these benefits persisted at one year. In multivariate analysis, UMIPIC enrollment remained protective (HR: 0.79; 95% CI: 0.71-0.87; <i>p</i> < 0.001). In men, UMIPIC patients were older with more comorbidities and higher HFpEF prevalence. They also showed lower 30-day mortality (2.0% vs. 8.0%; <i>p</i> < 0.05) and readmissions (8.0% vs. 18.0%; <i>p</i> < 0.01), with benefits maintained at one year. UMIPIC enrollment remained independently associated with reduced one-year mortality in men (HR: 0.79; 95% CI: 0.71-0.88; <i>p</i> < 0.001). <b>Conclusions:</b> The UMIPIC multidisciplinary care model reduced one-year mortality and readmissions in both women and men with HF, supporting integrated care strategies to improve outcomes in this high-risk population.

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Journal
Journal of Clinical Medicine
Published
2025-08-17
DOI
https://doi.org/10.3390/jcm14165818
Primary Topic
Heart Failure Treatment and Management
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article
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article

Are There Gender Differences in the Benefits of Multidisciplinary Care in Patients with Heart Failure? Results from the UMIPIC Program

Pau Llàcer, Jesús Casado, Manuel Méndez‐Bailón, José Carlos Arévalo‐Lorido et al.
Journal of Clinical Medicine
Heart Failure Treatment and Management
article

Are There Gender Differences in the Benefits of Multidisciplinary Care in Patients with Heart Failure? Results from the UMIPIC Program

Pau Llàcer, Jesús Casado, Manuel Méndez‐Bailón, José Carlos Arévalo‐Lorido, Françesc Formiga, Álvaro González Franco, Prado Salamanca‐Bautista, José Pérez-Silvestre, Manuel Montero-Pérez-Barquero, Alicia Conde‐Martel, Luís Manzano, José María Fernández Rodríguez
article en

Abstract

<b>Background/Objectives</b>: Heart failure (HF) is a leading cause of hospitalization in older adults, with significant sex differences in presentation, treatment, and outcomes. Transitional care models may benefit women more, yet they often receive less follow-up. This study assessed whether the clinical impact of the UMIPIC multidisciplinary HF management program differs by sex. <b>Methods:</b> This prospective, multicenter, observational cohort study included HF patients enrolled in the UMIPIC program or followed through conventional care in the RICA registry. Outcomes (30-day and one-year mortality and readmissions) were compared between groups, stratified by sex. Multivariate Cox models adjusted for age, HF phenotype, comorbidities, and baseline therapy. <b>Results:</b> A total of 5644 HF patients were included, with 2034 (36%) managed in UMIPIC and 3610 (64%) receiving conventional care. Women represented 55% of UMIPIC patients and were older, with higher prevalence of hypertension, anemia, and HF with preserved ejection fraction (HFpEF) compared to conventional care. At 30 days, women in UMIPIC had lower all-cause mortality (4.0% vs. 8.0%), cardiovascular mortality (2.0% vs. 6.0%), and readmissions (9.0% vs. 18.0%; all <i>p</i> < 0.01); these benefits persisted at one year. In multivariate analysis, UMIPIC enrollment remained protective (HR: 0.79; 95% CI: 0.71-0.87; <i>p</i> < 0.001). In men, UMIPIC patients were older with more comorbidities and higher HFpEF prevalence. They also showed lower 30-day mortality (2.0% vs. 8.0%; <i>p</i> < 0.05) and readmissions (8.0% vs. 18.0%; <i>p</i> < 0.01), with benefits maintained at one year. UMIPIC enrollment remained independently associated with reduced one-year mortality in men (HR: 0.79; 95% CI: 0.71-0.88; <i>p</i> < 0.001). <b>Conclusions:</b> The UMIPIC multidisciplinary care model reduced one-year mortality and readmissions in both women and men with HF, supporting integrated care strategies to improve outcomes in this high-risk population.

Journal of Clinical MedicineVol. 14(16)
Universidad de Las Palmas de Gran Canaria (ES), Universidad Complutense de Madrid (ES), Universidad de Alcalá (ES), Bellvitge University Hospital (ES), Hospital Universitario Virgen Macarena (ES), Instituto Maimónides de Investigación Biomédica de Córdoba (ES), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (ES), Hospital Universitario de Gran Canaria Doctor Negrín (ES), Hospital Carmen y Severo Ochoa (ES), Hospital Universitario de Getafe (ES), Instituto de Arqueología-Mérida (ES), Madrid Health Service (ES), Instituto Ramón y Cajal de Investigación Sanitaria (ES), Hospital General Universitario De Valencia (ES), Hospital Universitario Central de Asturias (ES), Hospital Universitario Lucus Augusti (ES), Hospital Universitario Ramón y Cajal (ES), Universidad de Sevilla (ES)
Openalex Percentile: Top 66%
Heart Failure Treatment and Management
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