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Profile and follow up of the elderly patient with heart failure

Session Poster Session 3

Speaker Daniel Enriquez Vazquez

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Comorbidities
  • Session type : Poster Session

Authors : D Enriquez Vazquez (Madrid,ES), CN Perez Garcia (Madrid,ES), M Ferrandez Escarabajal (Madrid,ES), TS Luque Diaz (Madrid,ES), A Travieso Gonzalez (Madrid,ES), M Perez Serrano (Madrid,ES), E Martinez Gomez (Madrid,ES), N Ramos Lopez (Madrid,ES), A Jeronimo Baza (Madrid,ES), C Olmos Blanco (Madrid,ES), D Vivas Balcones (Madrid,ES), J Goirigolzarri (Madrid,ES), R Bover Freire (Madrid,ES), I Vilacosta (Madrid,ES), C Macaya (Madrid,ES)

Authors:
D Enriquez Vazquez1 , CN Perez Garcia1 , M Ferrandez Escarabajal1 , TS Luque Diaz1 , A Travieso Gonzalez1 , M Perez Serrano1 , E Martinez Gomez1 , N Ramos Lopez1 , A Jeronimo Baza1 , C Olmos Blanco1 , D Vivas Balcones1 , J Goirigolzarri1 , R Bover Freire1 , I Vilacosta1 , C Macaya1 , 1Hospital Clinic San Carlos, Cardiovascular Institute - Madrid - Spain ,

Citation:

Introduction
The prevalence of heart failure (HF) has increased, due to the increased survival of these patients. The elderly patient sometimes presents multiple comorbidities. 

Therefore, the objective of this study is to know this subgroup more and more frequent, and its follow-up.

Methods
Patients with a diagnosis of HF admitted to a Cardiology Service of a tertiary hospital between July 2016 and March 2017 have been collected prospectively and consecutively, recording their characteristics and management, and their follow up.

Results
Of the total of 336 patients analyzed, 150 patients were 80 years old or older, with a median follow-up of 403 days. Baseline characteristics of these patients are in Table 1. Less impact has been placed on the control of heart rate (HR) in these patients, presenting at discharge an average HR at discharge of 81.65 vs 69.85 bpm in those under 80 years of age. (p 0.024). Within depressed LVEF patients, a lower percentage of beta-blockers was used in elderly patients (70.97% vs 84.26%, p 0.039) as well as ACEi or ARA2 (56.45% vs 72, 22%; p 0.036) and mineralocorticoid receptor antagonists (38.71% vs 62.04%; p 0.003). The use of devices has been significantly lower, with a percentage of 0% DAI vs 4.9% in the younger age group (p 0.007). The profile of diuretics used was different, with greater use of thiazides in elderly patients (6.35% vs. 1.83%, p 0.014). In the follow-up, the group of elderly patients presented higher mortality (p 0.05), the main cause being the HF.

Conclusion
Elderly patient admitted with HF are mostly women, predominantly with preserved EF, hypertension, and worse baseline. Indicated drugs were used in a lower percentage. Mortality is higher in this subgroup, mainly due to HF.

Characteristics

80 years or older

Younger patients

p value

Mean age (years)

84,69

68,76

<0,001

Sex women

59,3%

38,2%

<0,001

Hypertension

89,3%

75,8%

0,001

Diabetes Mellitus

43,3%

48,9%

0,307

Dyslipemia

68%

59,1%

0,094

Smoker

4%

14,5%

0,001

Atrial fibrillation

62,7%

48,4%

0,009

Dependiente o parcialmente dependiente

22%

10,8%

0,019

Mean EF

44,306

49,989

0,004

Preserved EF

60,66%

44,62%

0,003

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