Being male or having diabetes confers a poorer prognosis in patients with heart failure, a large meta-analysis in the European Journal of Heart Failure has shown. The authors used data from 31 studies in the Meta-Analysis Global Group In Chronic Heart Failure (MAGGIC) of 41,949 patients with heart failure of which 28,052 were men and 13,897 women. Dr Peter Savill GP Watercress Medical, Medstead, GPwSI Cardiology, Southampton, writes: 'The authors note that women with ischaemic heart failure present more like men probably because the effect of an acute event such as a myocardial infarction negates the degree of protection from being female unlike the more gradual process of a non-ischaemic cardiomyopathy. Furthermore, diabetes patients with heart failure are known to have a poorer prognosis and again less of a gender effect is seen.'