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Optimised management of over-80-year-old heart failure patient improves outcomes: HF80 Pilot randomised study

Session Poster session 1 Saturday 08:30 -17:30

Speaker

Congress : Heart Failure 2015

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure
  • Session type : Poster Session
  • FP Number : P245

Authors : C Vorilhon (Clermont-Ferrand,FR), F Jean (Clermont-Ferrand,FR), B Pereira (Clermont-Ferrand,FR), G Clerfond (Clermont-Ferrand,FR), A Mulliez (Clermont-Ferrand,FR), V Sapin (Clermont Ferrand,FR), P Motreff (Clermont-Ferrand,FR), B Citron (Clermont-Ferrand,FR), JR Lusson (Clermont-Ferrand,FR), R Eschalier (Clermont-Ferrand,FR)

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Authors:
C Vorilhon1 , F Jean1 , B Pereira2 , G Clerfond1 , A Mulliez2 , V Sapin3 , P Motreff1 , B Citron1 , JR Lusson1 , R Eschalier1 , 1University Hospital Gabriel Montpied, Cardiology - Clermont-Ferrand - France , 2University Hospital Gabriel Montpied, Biostatistics unit - Clermont-Ferrand - France , 3University Hospital Gabriel Montpied, Biology - Clermont Ferrand - France ,

Citation:
European Journal of Heart Failure Abstracts Supplement ( 2015 ) 17 ( Supplement 1 ), 50

Introduction: The prevalence and incidence of heart failure (HF) in elderly patients are increasing worldwide. The management of HF with reduced left ventricular ejection fraction (HFREF) in over-80-year-old patients follows international guidelines despite the lack of a dedicated study. The question therefore remains: is there a benefit in optimising the management of HF with reduced LVEF in over-80-year-old?

Materials and methods: The HF80 pilot study is a prospective study. Over-80-year-old patients hospitalised for HFREF were randomised in an optimised group (optimised management) or a control group (usual care). Primary endpoint was quality of life (QoL) at 6 months (Minnesota Questionnaire).

Results: The trial was stopped prematurely, according to prespecified rules, after thirty-four patients were included (n = 17 in each group). There was no difference in QoL at baseline and at 6 months between the 2 groups (p = 0.14 and p = 0.64, respectively), although a significant improvement was observed between baseline and 6 months in the optimised group as opposed to the control group (−20.2 ± 25.2, p = 0.01 vs. −9.9 ± 19.0, p = 0.19). Mortality at 12 months was lower in the optimised group (17.7% vs. 47.1%, p = 0.047). There was no increase in acute renal failure, hyperkalaemia or falls in the optimised group (p = 0.49, p = 1, p = 1, respectively). Moreover, ACE inhibitors were significantly less reduced or halted (p = 0.04) while beta-blockers were further increased (p = 0.003) in this group.

Conclusions: Optimising the management of HFREF in over-80-year-old patients, according to the modalities of the HF80 Pilot Study, is both effective (improved QoL at 6 months and decreased mortality at 12 months) and safe (no observable increase in side-effects).



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