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Clinical Impact of Worsening Renal Function in Elderly Patients with Acute Decompensated Heart Failure

BACKGROUND AND OBJECTIVES: The clinical significance of worsening renal function (WRF) in elderly patients with acute decompensated heart failure (ADHF) is not completely understood. We compared the clinical conditions between younger and elderly patients with ADHF after the appearance of WRF to est...

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Autores principales: Sawamura, Akinori, Kajiura, Hiroki, Sumi, Takuya, Umemoto, Norio, Sugiura, Tsuyoshi, Taniguchi, Toshio, Ohashi, Masako, Asai, Toru, Shimizu, Kiyokazu, Murohara, Toyoaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Heart Failure 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536691/
https://www.ncbi.nlm.nih.gov/pubmed/36262877
http://dx.doi.org/10.36628/ijhf.2020.0050
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author Sawamura, Akinori
Kajiura, Hiroki
Sumi, Takuya
Umemoto, Norio
Sugiura, Tsuyoshi
Taniguchi, Toshio
Ohashi, Masako
Asai, Toru
Shimizu, Kiyokazu
Murohara, Toyoaki
author_facet Sawamura, Akinori
Kajiura, Hiroki
Sumi, Takuya
Umemoto, Norio
Sugiura, Tsuyoshi
Taniguchi, Toshio
Ohashi, Masako
Asai, Toru
Shimizu, Kiyokazu
Murohara, Toyoaki
author_sort Sawamura, Akinori
collection PubMed
description BACKGROUND AND OBJECTIVES: The clinical significance of worsening renal function (WRF) in elderly patients with acute decompensated heart failure (ADHF) is not completely understood. We compared the clinical conditions between younger and elderly patients with ADHF after the appearance of WRF to establish its prognostic influence. METHODS: We included 654 consecutive patients (37% women) admitted for ADHF. We divided the patients into four groups according to their age (<80 years, under-80, n=331; ≥80 years, over-80, n=323) and to their WRF statuses (either WRF or non-WRF group). We defined WRF as an increase in serum creatinine level ≥0.3 mg/dL or ≥150% within 48 hours after hospital arrival (under-80, n=62; over-80, n=75). The primary endpoint was a composite of cardiac events within 1 year. RESULTS: The survival analyses revealed that the WRF group had significantly more cardiac events than the non-WRF group in patients in the over-80 group (log-rank p=0.025), but not in those of the under-80 group (log-rank p=0.50). The patients in the over-80, WRF group presented more significant mean blood pressure (MBP) drops than those in the over-80 non-WRF group (p=0.003). Logistic regression analyses revealed that higher MBP at admission was a significant predictor of WRF. CONCLUSIONS: WRF is a predictor of poor outcomes in elderly patients with ADHF.
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spelling pubmed-95366912022-10-18 Clinical Impact of Worsening Renal Function in Elderly Patients with Acute Decompensated Heart Failure Sawamura, Akinori Kajiura, Hiroki Sumi, Takuya Umemoto, Norio Sugiura, Tsuyoshi Taniguchi, Toshio Ohashi, Masako Asai, Toru Shimizu, Kiyokazu Murohara, Toyoaki Int J Heart Fail Original Article BACKGROUND AND OBJECTIVES: The clinical significance of worsening renal function (WRF) in elderly patients with acute decompensated heart failure (ADHF) is not completely understood. We compared the clinical conditions between younger and elderly patients with ADHF after the appearance of WRF to establish its prognostic influence. METHODS: We included 654 consecutive patients (37% women) admitted for ADHF. We divided the patients into four groups according to their age (<80 years, under-80, n=331; ≥80 years, over-80, n=323) and to their WRF statuses (either WRF or non-WRF group). We defined WRF as an increase in serum creatinine level ≥0.3 mg/dL or ≥150% within 48 hours after hospital arrival (under-80, n=62; over-80, n=75). The primary endpoint was a composite of cardiac events within 1 year. RESULTS: The survival analyses revealed that the WRF group had significantly more cardiac events than the non-WRF group in patients in the over-80 group (log-rank p=0.025), but not in those of the under-80 group (log-rank p=0.50). The patients in the over-80, WRF group presented more significant mean blood pressure (MBP) drops than those in the over-80 non-WRF group (p=0.003). Logistic regression analyses revealed that higher MBP at admission was a significant predictor of WRF. CONCLUSIONS: WRF is a predictor of poor outcomes in elderly patients with ADHF. Korean Society of Heart Failure 2021-03-29 /pmc/articles/PMC9536691/ /pubmed/36262877 http://dx.doi.org/10.36628/ijhf.2020.0050 Text en Copyright © 2021. Korean Society of Heart Failure https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Sawamura, Akinori
Kajiura, Hiroki
Sumi, Takuya
Umemoto, Norio
Sugiura, Tsuyoshi
Taniguchi, Toshio
Ohashi, Masako
Asai, Toru
Shimizu, Kiyokazu
Murohara, Toyoaki
Clinical Impact of Worsening Renal Function in Elderly Patients with Acute Decompensated Heart Failure
title Clinical Impact of Worsening Renal Function in Elderly Patients with Acute Decompensated Heart Failure
title_full Clinical Impact of Worsening Renal Function in Elderly Patients with Acute Decompensated Heart Failure
title_fullStr Clinical Impact of Worsening Renal Function in Elderly Patients with Acute Decompensated Heart Failure
title_full_unstemmed Clinical Impact of Worsening Renal Function in Elderly Patients with Acute Decompensated Heart Failure
title_short Clinical Impact of Worsening Renal Function in Elderly Patients with Acute Decompensated Heart Failure
title_sort clinical impact of worsening renal function in elderly patients with acute decompensated heart failure
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536691/
https://www.ncbi.nlm.nih.gov/pubmed/36262877
http://dx.doi.org/10.36628/ijhf.2020.0050
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