PMID- 11773911
OWN - NLM
STAT- MEDLINE
DCOM- 20020125
LR  - 20220331
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 143
IP  - 1
DP  - 2002 Jan
TI  - Clinical features and outcomes of elderly outpatients with heart failure followed 
      up in hospital cardiology units: data from a large nationwide cardiology database 
      (IN-CHF Registry).
PG  - 45-55
AB  - BACKGROUND: Congestive heart failure (HF) represents a major public health 
      problem with an age-related increasing prevalence. Despite the high mortality and 
      morbidity in elderly patients with HF, limited clinical and prognostic data are 
      available for development of appropriate prevention and treatment strategies. 
      METHODS: A cohort of 3327 outpatients consecutively enrolled in the Registry of 
      Italian Network on Congestive Heart Failure by 133 cardiology centers was 
      studied. Univariate and multivariate analyses were performed to compare patients 
      <70 and > or =70 years old and to evaluate associations between clinical 
      variables and the 1-year mortality rate and hospitalizations. RESULTS: With 
      respect to the 2294 patients <70 years old, the 1033 (31%) elderly patients were 
      significantly more likely to be female, to be in New York Heart Association 
      (NYHA) class III-IV, and to have preserved left ventricular systolic function 
      (ejection fraction >40%), an ischemic/valvular etiology, and atrial 
      fibrillation/flutter. Elderly patients received angiotensin-converting enzyme 
      inhibitors, beta-blockers, and anticoagulants less frequently than younger 
      patients did. The 1-year mortality rate was significantly higher in patients > or 
      =70 years old (22% vs 13.7%, P <.001). Age was an independent predictor of 1-year 
      mortality, increasing 2.8% by each year of age. Independent predictors of 1-year 
      mortality in elderly patients were (1) > or =1 hospital admission in the previous 
      year (relative risk [RR] 2.09, 95% CI 1.51-2.87), (2) systolic blood pressure (RR 
      0.98, 95% CI 0.97-0.99), (3) NYHA class III-IV (RR 1.57, 95% CI 1.20-2.07), and 
      (4) age (RR 1.028, 95% CI 1.001-1.056). CONCLUSIONS: Our study confirms that 
      elderly patients (1) are seen in a more advanced stage of HF, (2) are less likely 
      to receive evidence-based treatments, (3) show more frequently preserved systolic 
      function, and (4) have a worse prognosis. Consequently, there is a need to 
      develop more effective and targeted management strategies for this escalating 
      health problem.
FAU - Pulignano, Giovanni
AU  - Pulignano G
AD  - Department of Cardiology, S. Camillo Hospital, Institute of Care and Research, 
      Rome, Italy. gipulig@tin.it
FAU - Del Sindaco, Donatella
AU  - Del Sindaco D
FAU - Tavazzi, Luigi
AU  - Tavazzi L
FAU - Lucci, Donata
AU  - Lucci D
FAU - Gorini, Marco
AU  - Gorini M
FAU - Leggio, Francesco
AU  - Leggio F
FAU - Porcu, Maurizio
AU  - Porcu M
FAU - Scherillo, Marino
AU  - Scherillo M
FAU - Opasich, Cristina
AU  - Opasich C
FAU - Di Lenarda, Andrea
AU  - Di Lenarda A
FAU - Senni, Michele
AU  - Senni M
FAU - Maggioni, Aldo Pietro
AU  - Maggioni AP
CN  - IN-CHF Investigators
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Analysis of Variance
MH  - Child
MH  - Coronary Disease/complications
MH  - Databases, Factual
MH  - Female
MH  - Heart Failure/*drug therapy/etiology/mortality
MH  - Humans
MH  - Hypertension/complications
MH  - Italy/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Outpatients
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Treatment Outcome
EDAT- 2002/01/05 10:00
MHDA- 2002/01/26 10:01
CRDT- 2002/01/05 10:00
PHST- 2002/01/05 10:00 [pubmed]
PHST- 2002/01/26 10:01 [medline]
PHST- 2002/01/05 10:00 [entrez]
AID - S0002870302528970 [pii]
AID - 10.1067/mhj.2002.119608 [doi]
PST - ppublish
SO  - Am Heart J. 2002 Jan;143(1):45-55. doi: 10.1067/mhj.2002.119608.