David J Whellan1, Amanda Stebbins2, Adrian F Hernandez2, Justin A Ezekowitz3, John J V McMurray4, Paul J Mather5, Vic Hasselblad2, Christopher M O'Connor2. 1. Thomas Jefferson University, Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA. Electronic address: david.whellan@jefferson.edu. 2. Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA. 3. Canadian VIGOUR Centre at the University of Alberta, Mazankowski Alberta Heart Institute, Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta, Canada. 4. Western Infirmary and the British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, United Kingdom. 5. Thomas Jefferson University, Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA.
Abstract
BACKGROUND: Younger age as an independent predictor of death or all-cause rehospitalization at 30 days post-randomization for hospitalized heart failure (HF) patients has not been well described. METHODS AND RESULTS: ASCEND-HF enrolled 7141 hospitalized acute HF patients (categorized by age: <45, 45 to <55, 55 to <65, 65 to <75, and ≥75 years) and followed them for 30 days to assess clinical outcomes, which included death or rehospitalization. Patients 45 to <55 years had the lowest percentages of death (1.4%) and total rehospitalizations (10.7%); percentages increased for younger (3.0% and 12.2%, respectively, for age <45 y) and older (5.8% and 12.5%, respectively, for age ≥75 y) patients. For those rehospitalized, the total HF-induced readmissions were highest in the youngest (68%) and declined with increasing age (P = .03). Although patients ≥55 years of age were more likely to die or be rehospitalized within 30 days of randomization for each additional 10 years of life, those <55 years of age had a significant reduction in death or HF rehospitalization for each 10-year increase in age (similar findings for death and HF rehospitalization). CONCLUSIONS: There is a dichotomous relationship between age and risk of death or rehospitalization, and death or HF rehospitalization-risk decreases as age increases up to age 55 years, then increases after age 55 years.
RCT Entities:
BACKGROUND: Younger age as an independent predictor of death or all-cause rehospitalization at 30 days post-randomization for hospitalized heart failure (HF) patients has not been well described. METHODS AND RESULTS: ASCEND-HF enrolled 7141 hospitalized acute HF patients (categorized by age: <45, 45 to <55, 55 to <65, 65 to <75, and ≥75 years) and followed them for 30 days to assess clinical outcomes, which included death or rehospitalization. Patients 45 to <55 years had the lowest percentages of death (1.4%) and total rehospitalizations (10.7%); percentages increased for younger (3.0% and 12.2%, respectively, for age <45 y) and older (5.8% and 12.5%, respectively, for age ≥75 y) patients. For those rehospitalized, the total HF-induced readmissions were highest in the youngest (68%) and declined with increasing age (P = .03). Although patients ≥55 years of age were more likely to die or be rehospitalized within 30 days of randomization for each additional 10 years of life, those <55 years of age had a significant reduction in death or HF rehospitalization for each 10-year increase in age (similar findings for death and HF rehospitalization). CONCLUSIONS: There is a dichotomous relationship between age and risk of death or rehospitalization, and death or HF rehospitalization-risk decreases as age increases up to age 55 years, then increases after age 55 years.
Authors: Noel Lorenzo Villalba; Belén Chiva Ballesteros; Laura De Pedro Álvarez; Pamen Delgado Mainar; Ángel Nieto Sánchez; Javier Marco Martínez; Elpidio Calvo Manuel; Manuel Méndez Bailon Journal: Pan Afr Med J Date: 2019-12-17