Clinical features of extremely elderly patients with heart failure

Aim: To investigate the clinical features of heart failure in extremely elderly patients.

Methods: We analyzed 1163 consecutive hospitalized heart failure patients. The patients were divided into an extremely elderly group (≥85 years-of-age, n = 88) and a non-extremely elderly group (<85 years-of-age, n = 1075).

Results: The extremely elderly group had higher rates of hypertension, chronic kidney disease, anemia, higher systolic blood pressure and lower body mass index, and lower use of β-blockers and anticoagulants compared with the non-extremely elderly group. During the mean follow-up period of 1038 days, the extremely elderly group had higher mortality compared with the non-extremely elderly group (P < 0.001). In multivariate analysis, in the non-extremely elderly group, age (HR 1.027, P < 0.001), body mass index (HR 0.919, P < 0.001), New York Heart Association III or IV (HR 3.626, P < 0.001), preserved ejection fraction (HR 0.553, P < 0.001), anemia (HR 1.941, P < 0.001), β-blockers (HR 0.695, P = 0.028) and renin-angiotensin system inhibitors (HR 0.603, P = 0.001) were independent predictors for all-cause death. In contrast, atrial fibrillation (HR 2.042, P = 0.015) and renin-angiotensin system inhibitors (HR 0.470, P = 0.014) were independent predictors for all-cause death in the extremely elderly group, suggesting that the prognostic factors were different between the two groups.

Conclusions: We should be careful of atrial fibrillation and renin-angiotensin system inhibitors in managing extremely elderly patients with heart failure. Geriatr Gerontol Int 2017; 17: 2194-2199.