Older age (≥85 years) in patients with HFpEF was associated with higher mortality compared to age ≤55 years (HR 6.9; 95% CI 4.2-11.4), though younger patients had a higher proportion of sudden death.
Observational (n=8,468)
Sí
How do clinical characteristics, mortality, mode of death, and quality of life vary across age groups in patients with HFpEF?
Younger patients with HFpEF have worse quality of life and a higher proportional risk of sudden cardiac death compared to older patients, who die more frequently from noncardiovascular causes.
Estimación del efecto: HR 6.9 (95% CI 4.2 to 11.4)
BACKGROUND: Although heart failure with preserved ejection fraction (HFpEF) is considered a disease of the elderly, younger patients are not spared from this syndrome. OBJECTIVES: This study therefore investigated the associations among age, clinical characteristics, and outcomes in patients with HFpEF. METHODS: Using data on patients with left ventricular ejection fraction ≥45% from 3 large HFpEF trials (TOPCAT Aldosterone Antagonist Therapy for Adults With Heart Failure and Preserved Systolic Function, I-PRESERVE Irbesartan in Heart Failure With Preserved Systolic Function, and CHARM Preserved Candesartan Cilexetil in Heart Failure Assessment of Reduction in Mortality and Morbidity), patients were categorized according to age: ≤55 years (n = 522), 56 to 64 years (n = 1,679), 65 to 74 years (n = 3,405), 75 to 84 years (n = 2,464), and ≥85 years (n = 398). This study compared clinical and echocardiographic characteristics, as well as mortality and hospitalization rates, mode of death, and quality of life across age categories. RESULTS: Younger patients (age ≤55 years) with HFpEF were more often obese, nonwhite men, whereas older patients with HFpEF were more often white women with a higher prevalence of atrial fibrillation, hypertension, and chronic kidney disease (eGFR <60 ml/min/1.73 m2). Despite fewer comorbidities, younger patients had worse quality of life compared with older patients (age ≥85 years). Compared with patients age ≤55 years, patients age ≥85 years had higher mortality (hazard ratio: 6.9; 95% confidence interval: 4.2 to 11.4). However, among patients who died, sudden death was, proportionally, the most common mode of death (p < 0.001) in patients age ≤55 years. In contrast, older patients (age ≥85 years) died more often from noncardiovascular causes (34% vs. 20% in patients age ≤55 years; p < 0.001). CONCLUSIONS: Compared with the elderly, younger patients with HFpEF were less likely to be white, were more frequently obese men, and died more often of cardiovascular causes, particularly sudden death. In contrast, elderly patients with HFpEF had more comorbidities and died more often from noncardiovascular causes. (Aldosterone Antagonist Therapy for Adults With Heart Failure and Preserved Systolic Function TOPCAT; NCT00094302; Irbesartan in Heart Failure With Preserved Systolic Function I-PRESERVE; NCT00095238; Candesartan Cilexetil in Heart Failure Assessment of Reduction in Mortality and Morbidity CHARM Preserved; NCT00634712).
Tromp et al. (Mon,) conducted a observational in Heart failure with preserved ejection fraction (HFpEF) (n=8,468). Older age (≥85 years) vs. Younger age (≤55 years) was evaluated on Mortality (HR 6.9, 95% CI 4.2 to 11.4). Older age (≥85 years) in patients with HFpEF was associated with higher mortality compared to age ≤55 years (HR 6.9; 95% CI 4.2-11.4), though younger patients had a higher proportion of sudden death.