(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.

Full Text (subscription or payment may be required)