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Management and Prognosis of Heart Failure in Octogenarians: Final Report from the KorAHF Registry

Treatment of heart failure (HF) in the elderly face many difficulties due to lack of robust evidence. We analyzed the outcome of HF in octogenarians using a nationwide HF registry. Among 5625 patients from the Korean Acute Heart Failure (KorAHF) registry, prognosis of octogenarian HF and the associa...

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Autores principales: Oh, Gyu Chul, Cho, Hyun-Jai, Lee, Sang Eun, Kim, Min-Seok, Kim, Jae-Joong, Choi, Jin-Oh, Jeon, Eun-Seok, Hwang, Kyung-Kuk, Chae, Shung Chull, Baek, Sang Hong, Kang, Seok-Min, Yoo, Byung-Su, Choi, Dong-Ju, Ahn, Youngkeun, Kim, Kye Hun, Cho, Myeong-Chan, Oh, Byung-Hee, Lee, Hae-Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074088/
https://www.ncbi.nlm.nih.gov/pubmed/32059515
http://dx.doi.org/10.3390/jcm9020501
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author Oh, Gyu Chul
Cho, Hyun-Jai
Lee, Sang Eun
Kim, Min-Seok
Kim, Jae-Joong
Choi, Jin-Oh
Jeon, Eun-Seok
Hwang, Kyung-Kuk
Chae, Shung Chull
Baek, Sang Hong
Kang, Seok-Min
Yoo, Byung-Su
Choi, Dong-Ju
Ahn, Youngkeun
Kim, Kye Hun
Cho, Myeong-Chan
Oh, Byung-Hee
Lee, Hae-Young
author_facet Oh, Gyu Chul
Cho, Hyun-Jai
Lee, Sang Eun
Kim, Min-Seok
Kim, Jae-Joong
Choi, Jin-Oh
Jeon, Eun-Seok
Hwang, Kyung-Kuk
Chae, Shung Chull
Baek, Sang Hong
Kang, Seok-Min
Yoo, Byung-Su
Choi, Dong-Ju
Ahn, Youngkeun
Kim, Kye Hun
Cho, Myeong-Chan
Oh, Byung-Hee
Lee, Hae-Young
author_sort Oh, Gyu Chul
collection PubMed
description Treatment of heart failure (HF) in the elderly face many difficulties due to lack of robust evidence. We analyzed the outcome of HF in octogenarians using a nationwide HF registry. Among 5625 patients from the Korean Acute Heart Failure (KorAHF) registry, prognosis of octogenarian HF and the association of guideline-directed medical therapy (GDMT) with mortality and readmissions were analyzed. Octogenarian patients (1185, 22.4%) showed a higher mortality, and males were especially at increased risk (HR (hazard ratio) 1.19, 95% CI 1.01–1.40). A J-curve association between blood pressure (BP) and mortality was observed regardless of age, but the nadir value was lower in octogenarians (123.8 vs. 127.9 mmHg for systolic blood pressure (SBP); 67.1 vs. 73.9 mmHg for diastolic blood pressure (DBP), p < 0.001). Use of GDMT in octogenarian patients with HF and reduced ejection fraction (EF) were inadequate (74.3%, 47.1%, and 46.1% in octogenarians vs. 78.4%, 59.8%, and 55.2% in non-elderly for renin-angiotensin system inhibitors, beta-blockers, and aldosterone antagonists, respectively; all p < 0.05). However, those on medications had a significant reduction in 6 month mortality. For octogenarians with HF and preserved EF, angiotensin receptor blocker use reduced hospitalizations for HF in men (HR 0.19, 95% CI 0.04–0.87), but not in women (p-interaction = 0.037). HF in octogenarians were found to have different characteristics compared with the non-elderly. However, adequate use of GDMT was still associated with improved survival, and more attention should be given to prescribing medications with clinical benefits.
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spelling pubmed-70740882020-03-19 Management and Prognosis of Heart Failure in Octogenarians: Final Report from the KorAHF Registry Oh, Gyu Chul Cho, Hyun-Jai Lee, Sang Eun Kim, Min-Seok Kim, Jae-Joong Choi, Jin-Oh Jeon, Eun-Seok Hwang, Kyung-Kuk Chae, Shung Chull Baek, Sang Hong Kang, Seok-Min Yoo, Byung-Su Choi, Dong-Ju Ahn, Youngkeun Kim, Kye Hun Cho, Myeong-Chan Oh, Byung-Hee Lee, Hae-Young J Clin Med Article Treatment of heart failure (HF) in the elderly face many difficulties due to lack of robust evidence. We analyzed the outcome of HF in octogenarians using a nationwide HF registry. Among 5625 patients from the Korean Acute Heart Failure (KorAHF) registry, prognosis of octogenarian HF and the association of guideline-directed medical therapy (GDMT) with mortality and readmissions were analyzed. Octogenarian patients (1185, 22.4%) showed a higher mortality, and males were especially at increased risk (HR (hazard ratio) 1.19, 95% CI 1.01–1.40). A J-curve association between blood pressure (BP) and mortality was observed regardless of age, but the nadir value was lower in octogenarians (123.8 vs. 127.9 mmHg for systolic blood pressure (SBP); 67.1 vs. 73.9 mmHg for diastolic blood pressure (DBP), p < 0.001). Use of GDMT in octogenarian patients with HF and reduced ejection fraction (EF) were inadequate (74.3%, 47.1%, and 46.1% in octogenarians vs. 78.4%, 59.8%, and 55.2% in non-elderly for renin-angiotensin system inhibitors, beta-blockers, and aldosterone antagonists, respectively; all p < 0.05). However, those on medications had a significant reduction in 6 month mortality. For octogenarians with HF and preserved EF, angiotensin receptor blocker use reduced hospitalizations for HF in men (HR 0.19, 95% CI 0.04–0.87), but not in women (p-interaction = 0.037). HF in octogenarians were found to have different characteristics compared with the non-elderly. However, adequate use of GDMT was still associated with improved survival, and more attention should be given to prescribing medications with clinical benefits. MDPI 2020-02-12 /pmc/articles/PMC7074088/ /pubmed/32059515 http://dx.doi.org/10.3390/jcm9020501 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Oh, Gyu Chul
Cho, Hyun-Jai
Lee, Sang Eun
Kim, Min-Seok
Kim, Jae-Joong
Choi, Jin-Oh
Jeon, Eun-Seok
Hwang, Kyung-Kuk
Chae, Shung Chull
Baek, Sang Hong
Kang, Seok-Min
Yoo, Byung-Su
Choi, Dong-Ju
Ahn, Youngkeun
Kim, Kye Hun
Cho, Myeong-Chan
Oh, Byung-Hee
Lee, Hae-Young
Management and Prognosis of Heart Failure in Octogenarians: Final Report from the KorAHF Registry
title Management and Prognosis of Heart Failure in Octogenarians: Final Report from the KorAHF Registry
title_full Management and Prognosis of Heart Failure in Octogenarians: Final Report from the KorAHF Registry
title_fullStr Management and Prognosis of Heart Failure in Octogenarians: Final Report from the KorAHF Registry
title_full_unstemmed Management and Prognosis of Heart Failure in Octogenarians: Final Report from the KorAHF Registry
title_short Management and Prognosis of Heart Failure in Octogenarians: Final Report from the KorAHF Registry
title_sort management and prognosis of heart failure in octogenarians: final report from the korahf registry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074088/
https://www.ncbi.nlm.nih.gov/pubmed/32059515
http://dx.doi.org/10.3390/jcm9020501
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