Younger patients (<40 years) with heart failure had lower 3-year mortality compared to elderly patients ≥80 years (16.5% vs 57.2%), despite having more severe left ventricular dysfunction.
Meta-Analysis (n=41,926)
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Do younger patients with heart failure have different clinical characteristics and mortality outcomes compared to older patients?
Younger patients with heart failure have distinct clinical profiles, including more severe left ventricular dysfunction but lower mortality rates compared to older patients.
Tasa de eventos absoluta: 16.5% vs 57.2%
AIM: Our understanding of heart failure in younger patients is limited. The Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) database, which consisted of 24 prospective observational studies and 7 randomized trials, was used to investigate the clinical characteristics, treatment, and outcomes of younger patients. METHODS AND RESULTS: Patients were stratified into six age categories: <40 (n = 876), 40-49 (n = 2638), 50-59 (n = 6894), 60-69 (n = 12 071), 70-79 (n = 13 368), and ≥80 years (n = 6079). Of 41 926 patients, 2.1, 8.4, and 24.8% were younger than 40, 50, and 60 years of age, respectively. Comparing young (<40 years) against elderly (≥80 years), younger patients were more likely to be male (71 vs. 48%) and have idiopathic cardiomyopathy (63 vs. 7%). Younger patients reported better New York Heart Association functional class despite more severe left ventricular dysfunction (median ejection fraction: 31 vs. 42%, all P < 0.0001). Comorbidities such as hypertension, myocardial infarction, and atrial fibrillation were much less common in the young. Younger patients received more disease-modifying pharmacological therapy than their older counterparts. Across the younger age groups (<40, 40-49, and 50-59 years), mortality rates were low: 1 year 6.7, 6.6, and 7.5%, respectively; 2 year 11.7, 11.5, 13.0%; and 3 years 16.5, 16.2, 18.2%. Furthermore, 1-, 2-, and 3-year mortality rates increased sharply beyond 60 years and were greatest in the elderly (≥80 years): 28.2, 44.5, and 57.2%, respectively. CONCLUSION: Younger patients with heart failure have different clinical characteristics including different aetiologies, more severe left ventricular dysfunction, and less severe symptoms. Three-year mortality rates are lower for all age groups under 60 years compared with older patients.
Wong et al. (Tue,) conducted a meta-analysis in Chronic heart failure (n=41,926). Younger age (<40 years) vs. Elderly age (≥80 years) was evaluated on 3-year mortality. Younger patients (<40 years) with heart failure had lower 3-year mortality compared to elderly patients ≥80 years (16.5% vs 57.2%), despite having more severe left ventricular dysfunction.