Antonio Teixeira1,2,3, Jiri Parenica4, Jin Joo Park5, Shiro Ishihara6, Khalid F AlHabib7, Said Laribi2,3,8, Aldo Maggioni9, Òscar Miró10, Naoki Sato6, Katsuya Kajimoto11, Alain Cohen-Solal2,3,12, Enrique Fairman13, Johan Lassus14, Christian Mueller15, William F Peacock16, James L Januzzi17, Dong-Ju Choi5, Patrick Plaisance2,8, Jindrich Spinar4, Alexandre Mebazaa1,2,3, Etienne Gayat2,3,18. 1. Department of Geriatry, Hôpitaux Universitaire Saint Louis - Lariboisière, Assistance Publique des Hôpitaux de Paris, Paris, France. 2. University Paris Diderot, Paris, France. 3. UMR-S 942, INSERM, Paris, France. 4. Department of Internal Medicine and Cardiology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic. 5. Cardiovascular Center, Division of Cardiology/Department of Internal Medicine, Seoul National University Bundang Hospital, South Korea. 6. Nippon Medical School Musashi-Kosugi Hospital, Japan. 7. King Fahad Cardiac Center, Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia. 8. Emergency Department, Hôpitaux Universitaire Saint Louis - Lariboisière, Assistance Publique des Hôpitaux de Paris, Paris, France. 9. ANMCO Research Centre, Firenze, Italy. 10. Emergency Department, Hospital Clinic, Barcelona, Emergency Medicine Investigation Group 'Emergency care: processes and diseases', IDIBAPS, Barcelona, Spain. 11. Division of Cardiology, Towa Hospital, Tokyo, Japan. 12. Department of Cardiology, Hôpitaux Universitaire Saint Louis - Lariboisière, Assistance Publique des Hôpitaux de Paris, Paris, France. 13. Sociedad Argentina de Cardiologia, Area de Investigacion SAC Azcuenaga, Buenos Aires, Argentina. 14. Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. 15. Department of Internal Medicine, University Hospital, Basel, Switzerland. 16. Emergency Medicine Institute, The Cleveland Clinic, Cleveland, Ohio, USA. 17. Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA. 18. Department of Anesthesiology and Critical Care Medicine, Hôpitaux Universitaire Saint Louis - Lariboisière, Assistance Publique des Hôpitaux de Paris, Paris, France.
Abstract
AIMS: To assess, according to age groups, patients' characteristics according to region of origin, the chronic therapeutic management, prognostic utility of clinical variables, and natriuretic peptides. METHODS AND RESULTS: The GREAT registry consisted of patients identified as presenting with acute heart failure at the emergency department. Four groups of patients were defined according to age: the young patient group (<65 years); 'middle-old' (65-74 years), 'old-old' (75-84 years) and the 'oldest-old' (85-94 years). Follow-up at 1 year was performed via personal contact or national data registries at 1 year. Dataset consisted of 14 758 patients aged up to 95 years, with the 'oldest-old' group being more prevalent in North America and Western Europe. The 30-day mortality rate were, respectively, 8.1%, 8.9%, 10.3%, and 16.3% among the four age groups and 1-year mortality rates were, respectively, 3.1%, 17.1%, 24.7%, and 39.9%. Chronic heart failure treatment was less frequently administered with age (percentage of the 'fully treated' group was 14% in the 'young' compared with 2% in the 'oldest-old' patient group). Reduced left ventricular ejection fraction was present in 70%, 62.3%, 52.5%, and 46.8% among the four age groups, respectively. The prognostic utility of most variables for short- and long-term outcome was attenuated with age, with the exception of natriuretic peptides. CONCLUSION: This study found a large heterogeneity in age among geographic regions and that the eldest are less likely to be treated in accordance with recommendations of current heart failure guidelines. Natriuretic peptide concentrations retained prognostic value in patients across age strata.
AIMS: To assess, according to age groups, patients' characteristics according to region of origin, the chronic therapeutic management, prognostic utility of clinical variables, and natriuretic peptides. METHODS AND RESULTS: The GREAT registry consisted of patients identified as presenting with acute heart failure at the emergency department. Four groups of patients were defined according to age: the young patient group (<65 years); 'middle-old' (65-74 years), 'old-old' (75-84 years) and the 'oldest-old' (85-94 years). Follow-up at 1 year was performed via personal contact or national data registries at 1 year. Dataset consisted of 14 758 patients aged up to 95 years, with the 'oldest-old' group being more prevalent in North America and Western Europe. The 30-day mortality rate were, respectively, 8.1%, 8.9%, 10.3%, and 16.3% among the four age groups and 1-year mortality rates were, respectively, 3.1%, 17.1%, 24.7%, and 39.9%. Chronic heart failure treatment was less frequently administered with age (percentage of the 'fully treated' group was 14% in the 'young' compared with 2% in the 'oldest-old' patient group). Reduced left ventricular ejection fraction was present in 70%, 62.3%, 52.5%, and 46.8% among the four age groups, respectively. The prognostic utility of most variables for short- and long-term outcome was attenuated with age, with the exception of natriuretic peptides. CONCLUSION: This study found a large heterogeneity in age among geographic regions and that the eldest are less likely to be treated in accordance with recommendations of current heart failure guidelines. Natriuretic peptide concentrations retained prognostic value in patients across age strata.
Authors: Francisco J Martín-Sánchez; Michael Christ; Òscar Miró; W Frank Peacock; John J McMurray; Héctor Bueno; Alan S Maisel; Louise Cullen; Martin R Cowie; Salvatore Di Somma; Elke Platz; Josep Masip; Uwe Zeymer; Christiaan Vrints; Susanna Price; Christian Mueller Journal: Int J Cardiol Date: 2016-07-18 Impact factor: 4.164
Authors: Ramon F Abarquez; Paul Ferdinand M Reganit; Carmen N Chungunco; Jean Alcover; Felix Eduardo R Punzalan; Eugenio B Reyes; Elleen L Cunanan Journal: ASEAN Heart J Date: 2016-03-08