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Researchers identify prognostic factors for elderly with chronic heart failure

10 Jan 2018

Researchers have identified prognostic factors associated with cardiovascular (CV) and non-CV mortality in elderly patients with chronic heart failure (CHF), and are calling for preventive measures to begin as early as the age of 65 years in patients with CHF. [Sato M, et al, AHA 2017, poster S5025]

A total of 4,876 patients with stage C/D CHF from the Japanese CHART-2 study were divided into three groups according to age (group 1, 64 years, n=1,521; group 2, 65–74 years, n=1,501; group 3, 75 years, n=1,845).

Overall, female patients had significantly lower non-CV mortality than male patients in group 2 (14.9 vs 21.8 percent; p=0.027) and group 3 (39.2 vs 55.9 percent; p<0.001). The proportion of non-CV death increased significantly after the age of 65 years in both males and females.

In patients <65 and 65 years of age, B-type natriuretic peptide (BNP) levels and history of stroke were associated with CV mortality, while BMI and history of cancer were associated with non-CV mortality.

Importantly, in patients 65 years of age, the researchers found additional factors associated with CV and non-CV mortality that were not prognostic in those aged <65 years. In these elderly patients, haemoglobin levels (hazard ratio [HR], 0.89; p<0.001) and history of hyperuricaemia (HR, 1.40; p=0.003) were associated with CV mortality, while haemoglobin levels (HR, 0.90; p=0.001), albumin levels (HR, 0.58; p<0.001), history of hyperuricaemia (HR, 1.35; p=0.006) and history of stroke (HR, 1.70; p<0.001) were associated with non-CV mortality.

“These results suggest that CHF management to prevent both CV and non-CV deaths should be initiated at least as early as the age of 65 years in the elderly,” the researchers concluded.

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Most Read Articles
4 days ago
The types of bariatric surgery differentially affect the risk of developing acute pancreatitis postoperatively, such that the risk is greater in patients who undergo vertical sleeve gastrectomy vs Roux-en-Y gastric bypass surgery, according to a study. Risk factors include younger age and presence of gallstones.
Yesterday
Concomitant use of psyllium fibres, taken before meals, appears to enhance the cholesterol-lowering effects of statins, according to a recent meta-analysis.
5 days ago
Smoking appears to increase the risk of abdominal aortic aneurysm, particularly among current smokers, reports a recent meta-analysis. The risk appears to taper with a lower number of cigarette sticks smoked per day.
6 days ago
Para-aortic irradiation appears to increase the risk of diabetes among testicular cancer (TC) survivors compared to surgery only, suggests a recent study.