Clinical profile, management, and mortality in very-elderly patients hospitalized with acute decompensated heart failure: An analysis from the ATTEND registry

Mizuno, Masayuki; Kajimoto, Katsuya; Sato, Naoki; Yumino, Dai; Minami, Yuichiro; Murai, Koji; Munakata, Ryo; Asai, Kuniya; Keida, Takehiko; Sakata, Yasushi; Hagiwara, Nobuhisa; Takano, Teruo

doi:10.1016/j.ejim.2015.08.015

Cited by 47 publications

(49 citation statements)

References 27 publications

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“…13,26 Based on previous reports, compared to patients aged less than 65 years, those aged 65 years or older are characterized by higher short-and long-term mortality after hospital discharge, and they are at an increased risk of hospital readmissions. 1,3,9,[26][27][28] In our analysis, there was no difference for in-hospital outcomes between patients aged less than 65 years and those aged 65 years or older, as well as in patients aged from 65 to 74 years and those aged 75 years or older. Those findings may be associated with the fact that there is still suboptimal ambulatory HF treatment in Poland (few outpatient HF clinics).…”

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confidence: 74%

“…In the study group, 266 patients were aged less than 65 years (34.8%), and 499 patients-65 criteria, the diagnosis of HF in the elderly may be difficult because of its unusual clinical manifestation and other comorbid conditions. 1,7 There is an ongoing discussion on optimal management of HF in older patients; however, there are no specific guidelines for HF treatment specific to seniors, recommended by the European Society of Cardiology (ESC). 2 Patients enrolled in randomized clinical trials are often young with a reduced left ventricular ejection fraction (LVEF) and do not represent the real-life population.…”

Section: -3mentioning

confidence: 99%

“…Since the clinical conditions of people aged from 65 to 74 years have improved and there is an increasing number of HF patients aged 75 years or older, it is important to reevaluate the threshold of what we consider "older age". 1 The aim of the study was to examine the clinical profile and 1-year outcomes of elderly Polish patients (aged ≥65 years) compared with younger patients (aged <65 years) hospitalized for HF decompensation. An additional subanalysis sought to determine clinical differences among elderly patients aged from 65 to 74 years and the veryelderly-aged 75 years or older.…”

Section: -3mentioning

confidence: 99%

“…Our observations confirm that HF etiology in the elderly is more likely to be ischemic or related to VHD. 1,15 The most frequent VHD in HF patients is aortic stenosis (in the present analysis, 14.1% of patients aged ≥65 years), which currently can be treated with classic surgery or transcatheter aortic valve implantation in symptomatic elderly patients. 16 In comparison, for younger patients aged less than 65 years, a more frequent reason of HF was dilated cardiomyopathy (27.1%), which in the majority of patients is diagnosed before the age of 50 years, based on the European Cardiomyopathy Pilot Registry.…”

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confidence: 99%

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Heart failure in elderly patients: differences in clinical characteristics and predictors of 1-year outcome in the Polish ESC-HF Long-Term Registry

Ozierański¹,

Balsam²,

Tymińska³

et al. 2016

Polish Archives of Internal Medicine

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hospitalization in the elderly and a great cost driver both for the health care system and for the patients themselves. 4,5 The amount of readmissions after HF hospitalization within 6 months of discharge exceeds 50%. 4,5 In Poland, HF is the most common cause of readmission for patients hospitalized for acute myocardial infarction (AMI-PL nationwide database).6 Despite strict diagnostic INTRODUCTION Improvements in the treatment of cardiovascular diseases have resulted in a steady increase in the prevalence of chronic heart failure (HF) in seniors.1 Approximately 50% to 80% of patients hospitalized for HF are aged 65 years or older, and more than half of them, 75 years or older. 1-3As industrialized populations age, this becomes a more pressing issue. HF is a leading cause of KEY WORDSelderly patients, heart failure, hospitalization, prognosis, registry ABSTRACT INTRODUCTION Heart failure (HF) is the leading cause of hospitalization in elderly patients. OBJECTIVES The aim of the study was to examine the clinical profile and 1-year outcomes of elderly patients (aged ≥65 years) compared with younger patients (aged <65 years) hospitalized for HF decompensation, as well as clinical differences among elderly patients aged 65-74 years and those aged ≥75 years. PATIENTS AND METHODSThe primary endpoint (PE; all-cause death) and the secondary endpoint (SE; all-cause death or rehospitalization for HF worsening) were assessed at 1 year in a group of 765 hospitalized Polish participants of the ESC-HF Long-Term Registry. RESULTSThe PE was observed in 9.1% of patients aged <65 years; 18.5% of those aged ≥65 years (P = 0.0001); 14.5% of those aged 65-74 years; and 21.6% of those aged ≥75 years (P = 0.07). The SE occurred in 28.0% of patients aged <65 years; 36.1% of those aged ≥65 years (P = 0.04); 29.2% of those aged 65-74 years; and 41.2% of those aged ≥75 years (P = 0.01). Independent predictors of the PE in patients aged ≥65 years were as follows: chronic obstructive pulmonary disease (COPD), systolic blood pressure (SBP), New York Heart Association (NYHA) class, β-blocker use; in patients aged 65-74 years: coronary revascularization, NYHA class, sodium, and creatinine; in patients aged ≥75 years: NYHA class and SBP. Independent predictors of the SE in patients aged ≥65 years were as follows: COPD, NYHA class, potassium, SBP, and physical activity; in patients aged <65 years: chronic kidney disease (CKD), NYHA, and SBP; in patients aged 65-74 years: NYHA and creatinine; and in patients aged ≥75 years, previous HF hospitalization, coronary artery disease, CKD, COPD, alcohol consumption, smoking, NYHA, and SBP.CONCLUSIONS Elderly patients with HF differed from younger patients in terms of long-term outcome and prognostic factors. There were also important differences within the elderly group itself.

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confidence: 74%

Section: -3mentioning

confidence: 99%

Section: -3mentioning

confidence: 99%

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confidence: 99%

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Heart failure in elderly patients: differences in clinical characteristics and predictors of 1-year outcome in the Polish ESC-HF Long-Term Registry

Ozierański¹,

Balsam²,

Tymińska³

et al. 2016

Polish Archives of Internal Medicine

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“…Moreover, the mortality rate and/or rate of rehospitalization within one year was 54.4%. Previous studies in Japan revealed that the in-hospital mortality rate was about 6% and the mortality rate and/or rate of re-hospitalization within one year of ADHF was about 40% (10)(11)(12). Therefore, the current study may have included patients who had more severe ADHF.…”

Section: The Severity Of Heart Failure In Subjectsmentioning

confidence: 99%

Experience with long-term administration of tolvaptan to patients with acute decompensated heart failure

Kiuchi

Fujii

Hisatake

et al. 2017

DD&T

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Acute heart failure syndrome in the elderly

Katsanos

Bakosis

Frogudaki

2017

Continuing Cardiol Educ

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Acute heart failure (AHF) in the elderly is becoming an increasingly common clinical problem, associated with very high in-hospital and long-term mortality rates. Elderly AHF patients, as opposed to younger ones, may have a different demographic, pathophysiological, clinical, and prognostic profile, and therefore, some carefully considered therapeutic adjustments may be warranted for their treatment. Patients with older age, shock, diabetes, renal failure, infection, confusion, and severe non-cardiac comorbidities may be at the highest mortality risk.Answer questions and earn CME: https://wileyhealthlearning.com/Activity2/ 5608945/Activity.aspx

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Clinical profile, management, and mortality in very-elderly patients hospitalized with acute decompensated heart failure: An analysis from the ATTEND registry

Cited by 47 publications

References 27 publications

Heart failure in elderly patients: differences in clinical characteristics and predictors of 1-year outcome in the Polish ESC-HF Long-Term Registry

Heart failure in elderly patients: differences in clinical characteristics and predictors of 1-year outcome in the Polish ESC-HF Long-Term Registry

Experience with long-term administration of tolvaptan to patients with acute decompensated heart failure

Acute heart failure syndrome in the elderly

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