TY - JOUR
T1 - Acute heart failure in the elderly
T2 - Differences in clinical characteristics, outcomes, and prognostic factors in the Veritas study
AU - Metra, Marco
AU - Cotter, Gad
AU - El-Khorazaty, Jill
AU - Davison, Beth A.
AU - Milo, Olga
AU - Carubelli, Valentina
AU - Bourge, Robert C.
AU - Cleland, John G.
AU - Jondeau, Guillaume
AU - Krum, Henry
AU - O'Connor, Christopher M.
AU - Parker, John D.
AU - Torre-Amione, Guillermo
AU - Van Veldhuisen, Dirk J.
AU - Rainisio, Maurizio
AU - Kobrin, Isaac
AU - McMurray, John J.
AU - Teerlink, John R.
N1 - Funding Information:
MM has received consulting incomes from Bayer, Novartis, and Servier. GC, JE, BAD, and OM are employees of Momentum Research, which has received research grants from Novartis, Corthera, Novocardia, Trevena, Merck, Amgen, Chanrx, Cardio 3, Sorbent, and Singulex. RB has conducted research sponsored by Actelion, has ongoing research sponsored by Gilead, a competitor of Actelion, and has served in Gilead's speakers bureau. JC, HK, and JDP have received honoraria from Actelion for steering committee activities. JDP has received consulting fees and honoraria from Servier and Novartis. JT has received funds from Actelion and is currently conducting research funded by Amgen, Cytokinetics, Novartis, and Trevena. All other authors report no potential conflict of interest.
Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - 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.
AB - 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.
KW - Heart failure
KW - age
KW - outcomes
UR - http://www.scopus.com/inward/record.url?scp=84923640227&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84923640227&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2014.12.012
DO - 10.1016/j.cardfail.2014.12.012
M3 - Article
C2 - 25573829
AN - SCOPUS:84923640227
VL - 21
SP - 179
EP - 188
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
SN - 1071-9164
IS - 3
ER -