Prognostic Comparison of Octogenarian vs. Non-Octogenarian With Acute Decompensated Heart Failure　― AURORA Study

Background: Acute decompensated heart failure (ADHF) is the main cause of hospitalization and death of octogenarians, but no data on the 1-year post-discharge mortality rate. We evaluated the clinical status and predictors of 1-year mortality in octogenarians with ADHF.Methods and Results: From the...

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Published in:Circulation Journal 2023/12/25, Vol.88(1), pp.103-109
Main Authors: Nishino, Masami, Egami, Yasuyuki, Kawanami, Shodai, Abe, Masaru, Ohsuga, Mizuki, Nohara, Hiroaki, Ukita, Kohei, Kawamura, Akito, Yasumoto, Koji, Tsuda, Masaki, Okamoto, Naotaka, Matsunaga-Lee, Yasuharu, Yano, Masamichi
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Language:English
Subjects:
Acute decompensated heart failure
Aftercare
Aged, 80 and over
Albumin
Antiplatelet agents
Heart Failure
Humans
Octogenarians
Patient Discharge
Platelet Aggregation Inhibitors
Prognosis
Risk Factors
Stroke Volume
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container_start_page 103
container_title Circulation Journal
container_volume 88
creator Nishino, Masami
Egami, Yasuyuki
Kawanami, Shodai
Abe, Masaru
Ohsuga, Mizuki
Nohara, Hiroaki
Ukita, Kohei
Kawamura, Akito
Yasumoto, Koji
Tsuda, Masaki
Okamoto, Naotaka
Matsunaga-Lee, Yasuharu
Yano, Masamichi
description Background: Acute decompensated heart failure (ADHF) is the main cause of hospitalization and death of octogenarians, but no data on the 1-year post-discharge mortality rate. We evaluated the clinical status and predictors of 1-year mortality in octogenarians with ADHF.Methods and Results: From the AURORA (Acute Heart Failure Registry in Osaka Rosai Hospital) study, we examined 1,246 hospitalized ADHF patients. We compared the in-hospital mortality rate and the proportion of heart failure (HF) with preserved ejection fraction (HFpEF) between octogenarians and non-octogenarians. After discharge we compared the 1-year mortality rate between these groups, and we also evaluated the predictors of death in both groups. The proportion of HFpEF among the in-hospital deaths of octogenarians was significantly higher than in non-octogenarians (46.2% vs. 15.0%, P=0.031). The 1-year mortality rate after discharge was significantly higher in the octogenarians than non-octogenarians (P=0.014). Multivariable Cox regression analysis revealed that albumin ≤3.0 g/dL and antiplatelet agents were useful predictors of 1-year death after discharge of octogenarians whereas chronic kidney disease was a predictor in the non-octogenarians.Conclusions: The proportion of HFpEF among in-hospital deaths of octogenarians with ADHF was high as compared with non-octogenarians. When octogenarians with ADHF have severe hypoalbuminemia and antiplatelet agents, early nutritional and medical interventions after discharge may be important to improve the 1-year prognosis.
doi_str_mv 10.1253/circj.CJ-23-0470
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We evaluated the clinical status and predictors of 1-year mortality in octogenarians with ADHF.Methods and Results: From the AURORA (Acute Heart Failure Registry in Osaka Rosai Hospital) study, we examined 1,246 hospitalized ADHF patients. We compared the in-hospital mortality rate and the proportion of heart failure (HF) with preserved ejection fraction (HFpEF) between octogenarians and non-octogenarians. After discharge we compared the 1-year mortality rate between these groups, and we also evaluated the predictors of death in both groups. The proportion of HFpEF among the in-hospital deaths of octogenarians was significantly higher than in non-octogenarians (46.2% vs. 15.0%, P=0.031). The 1-year mortality rate after discharge was significantly higher in the octogenarians than non-octogenarians (P=0.014). Multivariable Cox regression analysis revealed that albumin ≤3.0 g/dL and antiplatelet agents were useful predictors of 1-year death after discharge of octogenarians whereas chronic kidney disease was a predictor in the non-octogenarians.Conclusions: The proportion of HFpEF among in-hospital deaths of octogenarians with ADHF was high as compared with non-octogenarians. When octogenarians with ADHF have severe hypoalbuminemia and antiplatelet agents, early nutritional and medical interventions after discharge may be important to improve the 1-year prognosis.</description><identifier>ISSN: 1346-9843</identifier><identifier>ISSN: 1347-4820</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-23-0470</identifier><identifier>PMID: 37793831</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Acute decompensated heart failure ; Aftercare ; Aged, 80 and over ; Albumin ; Antiplatelet agents ; Heart Failure ; Humans ; Octogenarians ; Patient Discharge ; Platelet Aggregation Inhibitors ; Prognosis ; Risk Factors ; Stroke Volume</subject><ispartof>Circulation Journal, 2023/12/25, Vol.88(1), pp.103-109</ispartof><rights>2024, THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-a144debb315ddf55fa587b79f09c24164e3f9359fc9827e47c8db655e49527203</citedby><cites>FETCH-LOGICAL-c470t-a144debb315ddf55fa587b79f09c24164e3f9359fc9827e47c8db655e49527203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37793831$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nishino, Masami</creatorcontrib><creatorcontrib>Egami, Yasuyuki</creatorcontrib><creatorcontrib>Kawanami, Shodai</creatorcontrib><creatorcontrib>Abe, Masaru</creatorcontrib><creatorcontrib>Ohsuga, Mizuki</creatorcontrib><creatorcontrib>Nohara, Hiroaki</creatorcontrib><creatorcontrib>Ukita, Kohei</creatorcontrib><creatorcontrib>Kawamura, Akito</creatorcontrib><creatorcontrib>Yasumoto, Koji</creatorcontrib><creatorcontrib>Tsuda, Masaki</creatorcontrib><creatorcontrib>Okamoto, Naotaka</creatorcontrib><creatorcontrib>Matsunaga-Lee, Yasuharu</creatorcontrib><creatorcontrib>Yano, Masamichi</creatorcontrib><title>Prognostic Comparison of Octogenarian vs. Non-Octogenarian With Acute Decompensated Heart Failure　― AURORA Study</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background: Acute decompensated heart failure (ADHF) is the main cause of hospitalization and death of octogenarians, but no data on the 1-year post-discharge mortality rate. We evaluated the clinical status and predictors of 1-year mortality in octogenarians with ADHF.Methods and Results: From the AURORA (Acute Heart Failure Registry in Osaka Rosai Hospital) study, we examined 1,246 hospitalized ADHF patients. We compared the in-hospital mortality rate and the proportion of heart failure (HF) with preserved ejection fraction (HFpEF) between octogenarians and non-octogenarians. After discharge we compared the 1-year mortality rate between these groups, and we also evaluated the predictors of death in both groups. The proportion of HFpEF among the in-hospital deaths of octogenarians was significantly higher than in non-octogenarians (46.2% vs. 15.0%, P=0.031). The 1-year mortality rate after discharge was significantly higher in the octogenarians than non-octogenarians (P=0.014). Multivariable Cox regression analysis revealed that albumin ≤3.0 g/dL and antiplatelet agents were useful predictors of 1-year death after discharge of octogenarians whereas chronic kidney disease was a predictor in the non-octogenarians.Conclusions: The proportion of HFpEF among in-hospital deaths of octogenarians with ADHF was high as compared with non-octogenarians. 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We evaluated the clinical status and predictors of 1-year mortality in octogenarians with ADHF.Methods and Results: From the AURORA (Acute Heart Failure Registry in Osaka Rosai Hospital) study, we examined 1,246 hospitalized ADHF patients. We compared the in-hospital mortality rate and the proportion of heart failure (HF) with preserved ejection fraction (HFpEF) between octogenarians and non-octogenarians. After discharge we compared the 1-year mortality rate between these groups, and we also evaluated the predictors of death in both groups. The proportion of HFpEF among the in-hospital deaths of octogenarians was significantly higher than in non-octogenarians (46.2% vs. 15.0%, P=0.031). The 1-year mortality rate after discharge was significantly higher in the octogenarians than non-octogenarians (P=0.014). Multivariable Cox regression analysis revealed that albumin ≤3.0 g/dL and antiplatelet agents were useful predictors of 1-year death after discharge of octogenarians whereas chronic kidney disease was a predictor in the non-octogenarians.Conclusions: The proportion of HFpEF among in-hospital deaths of octogenarians with ADHF was high as compared with non-octogenarians. When octogenarians with ADHF have severe hypoalbuminemia and antiplatelet agents, early nutritional and medical interventions after discharge may be important to improve the 1-year prognosis.</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>37793831</pmid><doi>10.1253/circj.CJ-23-0470</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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source Freely Accessible Medical Journals
subjects Acute decompensated heart failure
Aftercare
Aged, 80 and over
Albumin
Antiplatelet agents
Heart Failure
Humans
Octogenarians
Patient Discharge
Platelet Aggregation Inhibitors
Prognosis
Risk Factors
Stroke Volume
title Prognostic Comparison of Octogenarian vs. Non-Octogenarian With Acute Decompensated Heart Failure　― AURORA Study
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