Marco Metra1, Gad Cotter2, Jill El-Khorazaty2, Beth A Davison2, Olga Milo2, Valentina Carubelli3, Robert C Bourge4, John G Cleland5, Guillaume Jondeau6, Henry Krum7, Christopher M O'Connor8, John D Parker9, Guillermo Torre-Amione10, Dirk J van Veldhuisen11, Maurizio Rainisio12, Isaac Kobrin13, John J McMurray14, John R Teerlink15. 1. Cardiology, The Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili, Brescia, Italy. Electronic address: metramarco@libero.it. 2. Momentum Research Inc., Durham, North Carolina, USA. 3. Cardiology, The Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili, Brescia, Italy. 4. Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. 5. National Heart and Lung Institute, Royal Brompton and Harefield Hospitals Trust, London, United Kingdom; Hull York Medical School, University of Hull, Kingston-upon-Hull, United Kingdom. 6. Service de Cardiologie, Hôpital Bichat, Paris, France. 7. Monash Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Australia. 8. Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA. 9. Division of Cardiology, Department of Medicine, Mount Sinai Hospital and the University of Toronto. 10. Houston Methodist Hospital, Houston, Texas and Tecnologico de Monterrey, Monterrey, Mexico. 11. University Medical Center, Groningen, the Netherlands. 12. AbaNovus, Sanremo, Italy. 13. Actelion Pharmaceuticals, Allschwil, Switzerland. 14. University of Glasgow, Glasgow, United Kingdom. 15. Section of Cardiology, San Francisco Veterans Affairs Medical Center and University of California San Francisco, San Francisco, California, USA.
Abstract
BACKGROUND: Acute heart failure (HF) is common in the elderly, but the association of age with clinical outcomes and prognostic factors has not been examined thoroughly. METHODS AND RESULTS: We analyzed the clinical and laboratory characteristics and the outcomes of 1,347 patients with acute HF enrolled in the VERITAS trial. Subjects were subdivided based on their median age of 72 years. Older patients had a higher prevalence of comorbidities and a higher prevalence of hypertension and atrial fibrillation. During a mean follow-up of 149 ± 61 days, 432 patients (32.1%) reached the composite end point of death, in-hospital worsening HF, or HF rehospitalization by 30 days, and 135 patients (10.4%) died by 90 days, with a worse outcome in elderly patients in both cases. At multivariable analysis, different variables were related with each of these outcomes in elderly compared with younger patients. Regarding deaths at 90 days, plasma urea nitrogen and hemoglobin levels were predictive only in the younger patients, whereas respiratory rate and albumin levels were associated with mortality only in the older patients. CONCLUSIONS:Elderly patients with acute HF have different clinical characteristics and poorer outcomes. Prognostic variables differ in elderly compared with younger patients.
RCT Entities:
BACKGROUND: Acute heart failure (HF) is common in the elderly, but the association of age with clinical outcomes and prognostic factors has not been examined thoroughly. METHODS AND RESULTS: We analyzed the clinical and laboratory characteristics and the outcomes of 1,347 patients with acute HF enrolled in the VERITAS trial. Subjects were subdivided based on their median age of 72 years. Older patients had a higher prevalence of comorbidities and a higher prevalence of hypertension and atrial fibrillation. During a mean follow-up of 149 ± 61 days, 432 patients (32.1%) reached the composite end point of death, in-hospital worsening HF, or HF rehospitalization by 30 days, and 135 patients (10.4%) died by 90 days, with a worse outcome in elderly patients in both cases. At multivariable analysis, different variables were related with each of these outcomes in elderly compared with younger patients. Regarding deaths at 90 days, plasma ureanitrogen and hemoglobin levels were predictive only in the younger patients, whereas respiratory rate and albumin levels were associated with mortality only in the older patients. CONCLUSIONS: Elderly patients with acute HF have different clinical characteristics and poorer outcomes. Prognostic variables differ in elderly compared with younger patients.
Authors: Òscar Miró; Frank W Peacock; John J McMurray; Héctor Bueno; Michael Christ; Alan S Maisel; Louise Cullen; Martin R Cowie; Salvatore Di Somma; Francisco J Martín Sánchez; Elke Platz; Josep Masip; Uwe Zeymer; Christiaan Vrints; Susanna Price; Alexander Mebazaa; Christian Mueller Journal: Eur Heart J Acute Cardiovasc Care Date: 2016-02-21
Authors: Camille Roubille; Benjamin Eduin; Cyril Breuker; Laetitia Zerkowski; Simon Letertre; Cédric Mercuzot; Jonathan Bigot; Guilhem Du Cailar; François Roubille; Pierre Fesler Journal: Intern Emerg Med Date: 2022-04-22 Impact factor: 5.472