Journal
IJC HEART & VASCULATURE
Volume 27, Issue -, Pages -Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcha.2020.100497
Keywords
Heart failure; Elderly; Prognosis; Observational study
Categories
Funding
- Japanese Ministry of Health, Labour, and Welfare
- Japanese Ministry of Education, Culture, Sports, Science, and Technology
- Agency for Medical Research and Development, Tokyo, Japan
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Background: Since most of the randomized clinical trials for heart failure (HF) were designed to exclude elderly patients, limited data are available on their clinical characteristics, prognosis, and prognostic factors. Methods: We compared clinical characteristics, prognosis, and prognostic factors among Stage C/D HF patients in our CHART-2 Study (N = 4876, mean 69 years, women 32%, 6.3-year follow-up) by age (G1, <= 64 years, N = 1521; G2, 65-74 years, N = 1510; and G3, >= 75 years, N = 1845). Results: From G1 to G3, the prevalence of women, left ventricular ejection fraction (LVEF) and plasma levels of B-type natriuretic peptide (BNP) increased (all P < 0.001). Similarly, 5-year mortality increased (9.9, 17.3 to 39.9%, P < 0.001) along with a decrease in proportion of cardiovascular death and an increase in non-cardiovascular death in both sexes. While all-cause and cardiovascular mortality was comparable between the sexes, women had significantly lower incidence of non-cardiovascular death than men in G2 and G3, which was attributable to the higher incidence of cancer death and pneumonia death in men than in women. Although NYHA functional class chronic kidney disease, cancer, LVEF, and BNP had sig- nificant impacts on all-cause death in all groups, their impacts were less evident in G3 as compared with G1. Conclusions: The elderly HF patients, as compared with younger HF patients, were characterized by more severe clinical background, increased proportion of non-cardiovascular death and worse prognosis with different impacts of prognostic factors across the age groups. (C) 2020 The Authors. Published by Elsevier B.V.
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