Mortality High for Moderate, Severe Heart Failure Patients
(HealthDay News) – For patients aged ≤80 years with moderate or severe heart failure, mortality is mainly associated with heart failure and its comorbidities, according to a study published online Nov. 6 in the Journal of the American College of Cardiology.
Tonje Thorvaldsen, MD, from the Karolinska Institute in Stockholm, and colleagues assessed observed and expected all-cause mortality using data from the Swedish Heart Failure Registry for 10,062 patients with New York Heart Association (NYHA) III-IV heart failure and ejection fraction <40%. Five pre-specified risk factors (systolic blood pressure ≤90mmHg; creatinine ≥160µmol/L; hemoglobin ≤120g/L; no renin-angiotensin system antagonist; and no β-blocker) were assessed as potential triggers for referral to an advanced heart failure center.
The researchers found that for those with NYHA III-IV, the one-year observed vs. expected survival was 90% vs. 99% for those aged ≤65 years; 79% vs. 97% for those aged 66–80 years; and 61% vs. 89% for those aged >80 years. The presence of one, two, or three to five of these risk factors conferred an independent hazard ratio for all-cause mortality in those ≤80 years of 1.4, 2.3 and 4.07, and one-year survival of 79%, 60%, and 39%, respectively (P<0.001).
"These patients may benefit from referral to an advanced heart failure center," the authors write.
Two authors disclosed financial ties to the medical device industry.