Octogenarians hospitalized for heart failure experienced higher in-hospital mortality than younger patients (13% vs. 5%, P<0.001) and were less likely to receive ACE inhibitors and beta-blockers.
Observational (n=10,692)
Yes
How do clinical characteristics, treatment, and short-term outcomes differ between octogenarians and younger patients hospitalized for heart failure?
Octogenarians hospitalized for heart failure have higher mortality, more preserved ejection fraction, and are significantly less likely to receive guideline-directed medical therapies like ACE inhibitors and beta-blockers compared to younger patients.
Absolute Event Rate: 13% vs 5%
p-value: p=<0.001
AIMS: Here, the aim is to study the management of octogenarians hospitalized for heart failure in Euro Heart Failure Survey I. Heart Failure (HF) is common in older people and associated with poor outcome. METHODS AND RESULTS: We compared clinical characteristics, treatment, and short-term outcomes in 2780 octogenarians (group A, median age 85 years) and in 7912 younger patients (group B, median age 69 years) enrolled in the Euro Heart Failure Survey I. There were 37% males in group A vs. 59% in group B (P < 0.001). Co-morbidities were more common in group A. Ejection fraction was measured only in 38% in group A vs. 65% in group B (P < 0.001) and when measured was preserved in 50 vs. 40% (P < 0.001). In-hospital and 12 weeks follow-up mortality were, respectively, 13 vs. 5% (P < 0.001) and 12 vs. 6% (P < 0.001) in groups A and B. Acute cardiac conditions and co-morbidity predicted mortality, whereas the use of angiotensin-converting enzyme inhibitor (ACE-I) and beta-blockers was associated with a better outcome. ACE-I and beta-blockers were used in 50 vs. 66% (P < 0.001) and 24 vs. 42% (P < 0.001) in groups A and B, respectively, whereas diuretics, digitalis, and nitrates were more commonly used in octogenarians. CONCLUSION: Preserved systolic function, multiple co-morbidities, and high mortality are observed in octogenarians with HF. In these patients, cardiac function is assessed in only a minority and treatments known to improve prognosis in younger patients under-utilized. Overall, the management of octogenarians with HF does not follow international guidelines.
Komajda et al. (Thu,) conducted a observational in Heart Failure (n=10,692). Octogenarians vs. Younger patients was evaluated on In-hospital mortality (p=<0.001). Octogenarians hospitalized for heart failure experienced higher in-hospital mortality than younger patients (13% vs. 5%, P<0.001) and were less likely to receive ACE inhibitors and beta-blockers.
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