Key result
Early tolvaptan in ADHF patients over 80 is linked to similar MACCE as those under 80.
Why the study?
The number of elderly patients with ADHF is increasing and often difficult to treat, motivating an evaluation of the efficacy, safety, and 1-year prognosis of early tolvaptan use.
Does the early use of tolvaptan have a different prognostic impact in elderly (>80 years) versus younger (<80 years) patients with acute decompensated heart failure?
Cohort (n=185)
Does the early use of tolvaptan have a different prognostic impact in elderly (>80 years) versus younger (<80 years) patients with acute decompensated heart failure?
Absolute Event Rate: 25% vs 20%
p-value: p=0.59
Early administration of tolvaptan in ADHF patients over 80 years old appears to have a similar safety and MACCE profile at one year compared to those under 80, despite higher expected all-cause mortality in the elderly.
May support early tolvaptan consideration in elderly ADHF; extends observational safety data but leaves open randomized confirmation.
The number of elderly patients with acute decompensated heart failure (ADHF) is increasing, and it is often difficult to treat. This study aimed to evaluate the efficacy and safety of using tolvaptan early after hospitalization in elderly patients with ADHF and the prognosis one year after hospitalization. This study enrolled 185 patients with ADHF who were admitted for the first time. Tolvaptan was administered within 24 h after admission. These patients were assigned to two groups: over 80 years old (n = 109) and under 80 years old (n = 76). There were no significant differences between the two groups in the occurrence of MACCE within one year (25% vs. 20%, p = 0.59). All-cause mortality was significantly higher in the over-80 group (12% vs. 2%, p = 0.01). There were no significant differences in the incidence of worsening renal failure (11% vs. 7%, p = 0.46) and hypernatremia (5% vs. 9%, p = 1.0), and in the duration of hospitalization (19.2 days vs. 18.8 days, p = 0.8). Tolvaptan might be effective and safe in elderly patients with ADHF, and there was no difference in the incidence of MACCE within one year.
No takes yet. Share an insight, caveat, or question.
Okada et al. (2023) conducted a cohort in Acute decompensated heart failure (ADHF) (n=185). Tolvaptan vs. Patients under 80 years old was evaluated on MACCE within one year (p=0.59). Early use of tolvaptan in ADHF patients over 80 years old was associated with similar rates of MACCE at one year compared to patients under 80 years old (25% vs. 20%, p=0.59).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: