Researchers have identified prognostic factors associated with cardiovascular (CV) and non-CV mortality in elderly patients with chronic heart failure (CHF), and are calling for preventive measures to begin as early as the age of 65 years in patients with CHF. [Sato M, et al, AHA 2017, poster S5025]

A total of 4,876 patients with stage C/D CHF from the Japanese CHART-2 study were divided into three groups according to age (group 1, ≤64 years, n=1,521; group 2, 65–74 years, n=1,501; group 3, ≥75 years, n=1,845).

Overall, female patients had significantly lower non-CV mortality than male patients in group 2 (14.9 vs 21.8 percent; p=0.027) and group 3 (39.2 vs 55.9 percent; p<0.001). The proportion of non-CV death increased significantly after the age of 65 years in both males and females.

In patients <65 and ≥65 years of age, B-type natriuretic peptide (BNP) levels and history of stroke were associated with CV mortality, while BMI and history of cancer were associated with non-CV mortality.

Importantly, in patients ≥65 years of age, the researchers found additional factors associated with CV and non-CV mortality that were not prognostic in those aged <65 years. In these elderly patients, haemoglobin levels (hazard ratio [HR], 0.89; p<0.001) and history of hyperuricaemia (HR, 1.40; p=0.003) were associated with CV mortality, while haemoglobin levels (HR, 0.90; p=0.001), albumin levels (HR, 0.58; p<0.001), history of hyperuricaemia (HR, 1.35; p=0.006) and history of stroke (HR, 1.70; p<0.001) were associated with non-CV mortality.

“These results suggest that CHF management to prevent both CV and non-CV deaths should be initiated at least as early as the age of 65 years in the elderly,” the researchers concluded.