Natriuretic peptide testing in veterans hospitalized with heart failure: Potential differences by sex.
Parul U Gandhi, Tessa Runels, Ling Han and 11 others
PMID 39970822WHAT IT FOUND
Women veterans hospitalized with heart failure were less likely than men to have a natriuretic peptide test on admission, even after accounting for clinical and facility factors.
Key findings
01A natriuretic peptide test was recorded on admission for 78.3% of patients.
02Women were tested less often than men (74.7% versus 78.4%).
03In the fully adjusted model, women had a 15% lower likelihood of testing than men.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is retrospective, so it cannot show that sex caused lower testing or that lower testing led to worse care. Women made up only 2.2% of the cohort (1,237 patients), which may limit power to detect associations in women. Ejection fraction data were missing for 64.3% of patients (36,003), so ejection fraction associations may be incomplete. Testing was counted only on the admission date, so tests done after admission were not included. Sex was taken from VA records and did not include self-reported gender identity. Anemia was defined using a hemoglobin cutpoint of 12.8 g/dL, which may overestimate anemia in women. The sample was limited to VA inpatients, so findings may not apply to other health systems.
Declared interests
The authors declared no known competing financial interests or personal relationships. The study was supported by operations funds from VA Women's Health Services within the Office of Patient Care Services.
The easy way to misread this
Do not read the lower testing rate as evidence that women had worse heart failure outcomes. The study measured testing on admission only and did not follow diagnosis, treatment, or patient outcomes.