Portal de investigação
Prognostic impact of neurohormonal modulation in very old patients with chronic heart failure
Data de publicação:
Autores da FMUP
Participantes de fora da FMUP
- Silva, JE
- Melo, N
- Ferreira, AI
- Silva, C
- Lume, MJ
- Pereira, J
- Araújo, JP
Unidades de investigação
Abstract
Background A gap in evidence exists concerning the survival-benefit of neurohormonal blockade in older patients with chronic heart failure (HF). The purpose of our study was to investigate the neurohormonal modulation therapy in older HF patients. Methods We retrospectively analysed data on chronic HF patients with systolic dysfunction from January 2012 to May 2018 at a central tertiary academic hospital in Porto, Portugal. Very old (VO) patients were those >= 80 years. Endpoint under analysis: all-cause mortality; patients were followed until January 2021. The prognostic impact of beta-blockers (BBs) and renin-angiotensin system inhibitors (RASi) use was assessed with a Cox-regression analysis adjusting for confounders. Results We studied 934 patients, 65.5% male; 45.3% had ischemic HF. BBs were used in 92.2% and RASi in 83.5%; 255 (27.3%) were VO patients. VO more often presented co-morbidities, were more symptomatic, presented worse renal function and higher BNP levels. BB prescription was similar in VO and non-VO patients, however RASi were less used in VO: 74.9% versus 86.7%, respectively. During a median follow-up of 47 months, 479 (51.3%) patients died: 71.4% among VO versus 43.7% in non-VO. BBs increased survival both in non-VO and VO-multivariate adjusted HRs of 0.57 (95% CI: 0.38-0.85) and 0.59 (0.36-0.97), respectively. A survival-benefit was also observed with RASi-adjusted HR of 0.71 (0.50-1.01) and 0.59 (0.42-0.83) in non-VO and VO. Conclusions VO patients with chronic HF with systolic dysfunction have a very ominous outcome. Neurohormonal modulation therapy appears to portend survival-benefit also in this particularly vulnerable subgroup of patients.
Dados da publicação
- ISSN/ISSNe:
- 0002-0729, 1468-2834
- Tipo:
- Article
- Páginas:
- -
- Link para outro recurso:
- www.scopus.com
Age and Ageing Oxford University Press
Citações Recebidas na Web of Science: 1
Citações Recebidas na Scopus: 1
Documentos
- Não há documentos
Filiações
Keywords
- heart failure; older patients; guideline directed medical therapy; pognosis
Proyectos asociados
O papel dos microRNA146a e microRNA155 na dor e progressão da osteoartrose.
Investigador Principal: Daniela Santos Oliveira
Estudo Observacional Académico (MicroRNA) . Grünenthal . 2021
Citar a publicação
Silva JE,Melo N,Ferreira AI,Silva C,Oliveira D,Lume MJ,Pereira J,Araújo JP,Lourenço P. Prognostic impact of neurohormonal modulation in very old patients with chronic heart failure. Age Ageing. 2022. 51. (4):afac076. IF:6,700. (1).
