| Abstrakt: |
Elderly patients ≥ 90 years with heart failure (HF) are rarely included in clinical trials. The aim of this study was to assess characteristics, therapy, and outcomes of very elderly patients after their first HF hospitalization compared to 80-89 years. Methods and Results: This is a prospective, observational study that included 157 HF patients ≥ 80 years (mean age 89.2 years, 36.7% male) hospitalized at the Military Medical Academy, Sofia between January 2016 and December 2017. We evaluate differences between different age groups within the very elderly cohort (80 to 89 years and ≥ 90), adjusting for comorbidities, echocardiographic parameters, and treatment. Outcomes of interest were mortality during hospitalization, 30-day and one-year mortality, and readmissions. When compared to 80-89 years group, the ≥ 90 years group had less ischaemic heart disease and hypertension, higher prevalence of atrial fi brillation, conduction abnormalities, chronic kidney disease, and anaemia (p < 0.01), lower body mass index (24.9 ± 4.7 vs. 23.5 ± 4.0 kg/m2, p = 0.011), lower systolic blood pressure on admission (131.5 ± 23.6 vs. 118.3 ± 18.2 mm Hg, p = 0.002), and higher one-year mortality (32.0% vs. 47.4%; p < 0.001). The most frequently used therapy for HF in patients ≥ 90 years when compared to 80-89 years was beta-blockers (65.3% vs. 37.2%, p = 0.01) and digitalis (30.8% vs. 21.3%, p = 0.02). Conclusions: The HF patients ≥ 90 years have high mortality and frequent readmission rates. The most frequently prescribed therapy for HF in this age group is betablockers and digitalis, which is most likely due to high prevalence of atrial fibrillation in these patients [ABSTRACT FROM AUTHOR] |
