detail content area
- Date2021-02-23 17:17
- Update2021-02-23 17:17
- CountersignatureDivision of Research Planning
Journal of Clinical Medicine, 2020.9, 501-0, DOI: https://doi.org/10.3390/jcm9020501
Management and Prognosis of Heart Failure in Octogenarians: Final Report from the KorAHF Registry
Gyu Chul Oh, Hyun-Jai Cho; Sang Eun Lee Min-Seok Kim; Jae-Joong Kim; Jin-Oh Choi; Eun-Seok Jeon; Kyung-Kuk Hwang; Shung Chull Chae; Sang Hong Baek; Seok-Min Kang; Byung-Su Yoo; Dong-Ju Choi; Youngkeun Ahn; Kye Hun Kim; Myeong-Chan Cho; Byung-Hee Oh; Hae-Young Lee
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.
- DOI: https://doi.org/10.3390/jcm9020501
- ISBN or ISSN: 2077-0383
- 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
- This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.