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Publications

Journal Article Epublish 2 citations

PubMed: 42495086 DOI: 10.1177/11795468251396355

Why Men Fare Worse: Understanding Gender Disparities in Systemic Sclerosis-Associated Pulmonary Hypertension.

Clin Med Insights Cardiol 20:11795468251396355

Authors: Francesca Coppi, Gianluca Pagnoni, Ashraf Nassar, Marco de Pinto, Amelia Spinella, Stefania Cerri, Valentina Selleri, Daniela Aschieri, Anna Vittoria Mattioli, Giuseppe Boriani, Francesco Fedele, Dilia Giuggioli, Marcello Pinti

Affiliations

  • Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Italy.
  • National Institute for Cardiovascular Research (INRC), Bologna, Italy.
  • Cardiology Unit, Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
  • Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Italy.
  • Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Italy.
  • Respiratory Diseases Unit, University Hospital of Modena, University of Modena Reggio Emilia, Italy.
  • Department of Life Sciences, University of Modena and Reggio Emilia, Italy.
  • Department of Quality of Life Sciences, Alma Mater University of Bologna, Italy.
  • Cardiology, Sapienza University of Rome, Italy.
  • San Raffaele Hospital, Cassino, Italy.

Abstract

OBJECTIVE

This study investigates gender disparities in clinical outcomes among patients with systemic sclerosis (SSc)-associated pulmonary arterial hypertension (PAH), focusing on cardiovascular events, right ventricular function, and survival.

INTRODUCTION

PAH is a severe and life-threatening complication of SSc, with male patients often experiencing worse outcomes despite its higher prevalence in women. Comparative data on gender differences in this population remain limited.

METHODS

We conducted a retrospective, single-center study including 61 patients with SSc-associated PAH (52 women, 9 men), confirmed by right heart catheterization. Clinical, serological, pulmonary, and echocardiographic data were analyzed. Differences between sexes in cardiovascular events, right ventricular dilation, and survival were evaluated using appropriate statistical methods.

RESULTS

Male patients had a significantly higher incidence of cardiovascular events (median: 2.00 vs 1.00 in women; P = .031) and a greater prevalence of right ventricular dilation (100.00% vs 44.23%; P = .002). Kaplan-Meier analysis demonstrated reduced cardiovascular event-free survival (P = .001) and overall survival (P = .014) in men. Although mortality was higher in men (88.89%) than in women (57.69%), the difference was not statistically significant (P = .134).

CONCLUSION

Men with SSc-associated PAH experience worse clinical outcomes, including more frequent cardiovascular events and reduced survival. The absence of estrogen's protective effects and the adverse influence of testosterone on cardiac remodeling may contribute to these disparities. These findings highlight the importance of early gender-specific risk stratification and the need for tailored therapeutic strategies to improve outcomes in this high-risk group.

MeSH

Sclerosis, Hypertension, Hypertension, Pulmonary, Prevalence, Scleroderma, Systemic