Reasons why patients suffering from chronic heart failure at very low risk for mortality die
| Autor: | Donatella Del Sindaco, Antonella Cherubini, Carlo Stefenelli, Giulia Barbati, Michele Senni, Carmine Mazzone, Giovanni Pulignano, Giulia Russo, Giovanni Cioffi, Luigi Tarantini, Giorgio Faganello, Andrea Di Lenarda |
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| Přispěvatelé: | Russo, G, Cioffi, G, Pulignano, G, Barbati, G, Tarantini, L, Del Sindaco, D, Mazzone, C, Cherubini, A, Faganello, G, Stefenelli, C, Senni, M, Di Lenarda, A, Russo, Giulia, Cioffi, Giovanni, Pulignano, Giovanni, Barbati, Giulia, Tarantini, Luigi, Del Sindaco, Donatella, Mazzone, Carmine, Cherubini, Antonella, Faganello, Giorgio, Stefenelli, Carlo, Senni, Michele, Di Lenarda, Andrea |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Prognosi Older age Renal function 030204 cardiovascular system & hematology Kidney Function Tests Risk Assessment 03 medical and health sciences 0302 clinical medicine Sex Factors Risk Factors Internal medicine medicine Humans 030212 general & internal medicine Renal Insufficiency Mortality Male gender Chronic heart failure Prognosis Renal dysfunction Medicine (all) Cardiology and Cardiovascular Medicine Aged Proportional Hazards Models Aged 80 and over Heart Failure Ejection fraction Proportional hazards model business.industry Age Factors Stroke Volume medicine.disease Surgery Quartile Italy Heart failure Chronic Disease Very low risk Female business |
| Popis: | Background A proper prognostic stratification is crucial for organizing an effective clinical management and treatment decision-making in patients with chronic heart failure (CHF). In this study, we selected and characterized a sub-group of CHF patients at very low risk for death aiming to assess predictors of death in subjects with an expected probability of 1-year mortality near to 5%. Methods We used the Cardiac and Comorbid Conditions HF (3C-HF) Score to identify CHF patients with the best mid-term prognosis. We selected patients belonging to the lowest quartile of 3C-HF score (≤9 points). Results We recruited 1777 consecutive CHF patients at 3 Italian Cardiology Units (age 76±10years, 43% female, 32% with preserved ejection fraction). Subjects belonging to the lowest quartile of 3C-HF score were 609. During a median follow-up of 21 [12–40] months, 48 of these patients (8%) died, and 561 (92%) survived. The variables that contributed to death prediction by Cox regression multivariate analysis were older age (HR 1.03[CI 1.00–1.07]; p =0.04), male gender (HR 2.93[CI 1.50–5.51]; p =0.002) and a higher degree of renal dysfunction (HR 0.96[CI 0.94–0.98]; p Conclusions The prognostic stratification of CHF patients by 3C-HF score allows one to select patients at different outcome and to identify the factors associated with death in outliers with a very low mortality risk at mid-term follow-up. The reasons why these patients do not outlive the matching part of subjects who expectedly survive are related to a declined renal function and unmodifiable conditions including older age and male gender. |
| Databáze: | OpenAIRE |
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