Octogenarians with heart failure had a higher incidence of cardiovascular death or HF hospitalization compared to younger patients (13.3 vs 9.5 per 100 person-years; aHR 1.40, 95% CI 1.32-1.48).
Meta-Analysis (n=40,131)
Yes
Does age ≥ 80 years worsen outcomes and treatment rates in patients with heart failure compared to younger patients?
Octogenarians with heart failure have worse health status, higher hospitalization and mortality rates, and are undertreated with evidence-based therapies compared to younger patients.
Effect estimate: aHR 1.40 (95% CI 1.32-1.48)
Absolute Event Rate: 13.3% vs 9.5%
AIMS: Although the prevalence of heart failure (HF) increases markedly with advancing age, surprisingly little is known about HF in the very elderly. The aim of this study was to describe the clinical characteristics and outcomes of octogenarians with HF. METHODS AND RESULTS: Individual participant meta-analysis of patients with HF and reduced, mildly reduced, and preserved ejection fraction (HFrEF, HFmrEF, and HFpEF, respectively) enrolled in eight large randomized trials. Overall, the proportion of octogenarians was 1518 of 20 168 patients (7.5%) with HFrEF, 610 of 4609 (13.2%) with HFmrEF, and 3130 of 15 354 (20.4%) with HFpEF. Regardless of HF phenotype, octogenarian patients were more often female and had more comorbidities, more symptoms and signs of congestion, and worse health status (but not quality of life), in comparison to patients aged <80 years. The incidence (per 100 person-years) of the composite of cardiovascular death or HF hospitalization was 13.3 (95% confidence interval CI 12.7-14.0) in octogenarians versus 9.5 (95% CI 9.3-9.7) in non-octogenarians (adjusted hazard ratio aHR 1.40, 95% CI 1.32-1.48). Each component of the composite was more frequent in octogenarians with rates of cardiovascular mortality of 7.0 (95% CI 6.5-7.4) per 100 person-years versus 4.9 (95% CI 4.8-5.1) in non-octogenarians (aHR 1.60, 95% CI 1.48-1.72, p < 0.001). Octogenarians received less evidence-based therapy, especially mineralocorticoid receptor antagonists, than younger patients. CONCLUSION: Despite worse health status and higher hospitalization and mortality rates, octogenarians were undertreated compared to younger patients.
Yang et al. (Wed,) conducted a meta-analysis in Heart Failure (n=40,131). Age ≥80 years (octogenarians) vs. Age <80 years (non-octogenarians) was evaluated on Composite of cardiovascular death or HF hospitalization (aHR 1.40, 95% CI 1.32-1.48). Octogenarians with heart failure had a higher incidence of cardiovascular death or HF hospitalization compared to younger patients (13.3 vs 9.5 per 100 person-years; aHR 1.40, 95% CI 1.32-1.48).
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