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Management and Prognosis of Heart Failure in Octogenarians: Final Report from the KorAHF Registry
  • Date2021-02-23 17:17
  • Update2021-02-23 17:17
  • CountersignatureDivision of Research Planning
  • Tel043-719-8033

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


Abstract

    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.



  • 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
  • This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.


This public work may be used under the terms of the public interest source This public work may be used under the terms of the public interest source
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