Functional improvement and biological variations with sacubitril-valsartan and dapaglifozine prescription in the elderly with chronic heart failure. 350 patients, 85 and over, 3 years follow-up

Abstract Background Frailty is common in patients with chronic heart failure (CHF) and is associated with poor outcomes. The natural history of frail patients with CHF is unknown. Methods Frailty was assessed using the clinical frailty scale (CFS) in 467 consecutive patients with CHF (67% male, median age 76 years, median NT-proBNP 1156 ng/L) attending a routine follow-up visit. Those with CFS > 4 were classified as frail. We investigated the relation between frailty and treatments, hospitalisation and death in patients with CHF. Results 206 patients (44%) were frail. Of 291 patients with HF with reduced ejection fraction (HeFREF), those who were frail (N = 117; 40%) were less likely to receive optimal treatment, with many not receiving a renin–angiotensin–aldosterone system inhibitor (frail: 25% vs. non-frail: 4%), a beta-blocker (16% vs. 8%) or a mineralocorticoid receptor antagonist (50% vs 41%). By 1 year, there were 56 deaths and 322 hospitalisations, of which 25 (45%) and 198 (61%), respectively, were due to non-cardiovascular (non-CV) causes. Most deaths (N = 46, 82%) and hospitalisations (N = 215, 67%) occurred in frail patients. Amongst frail patients, 43% of deaths and 64% of hospitalisations were for non-CV causes; 58% of cardiovascular (CV) deaths were due to advancing HF. Among non-frail patients, 50% of deaths and 57% of hospitalisations were for non-CV causes; all CV deaths were due to advancing HF. Conclusion Frailty in patients with HeFREF is associated with sub-optimal medical treatment. Frail patients are more likely to die or be admitted to hospital, but whether frail or not, many events are non-CV. Graphical abstract

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Calcium Channel Autoantibodies Predicted Sudden Cardiac Death and All-Cause Mortality in Patients with Ischemic and Nonischemic Chronic Heart Failure

Disease Markers ◽

10.1155/2014/796075 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 8

Author(s):

Haiyun Yu ◽

Juanhui Pei ◽

Xiaoyan Liu ◽

Jingzhou Chen ◽

Xian Li ◽

...

Keyword(s):

Heart Failure ◽

Multivariate Analysis ◽

Sudden Cardiac Death ◽

Chronic Heart Failure ◽

Cardiac Death ◽

Independent Predictor ◽

All Cause Mortality ◽

Patient Prognosis ◽

The Relationship

The purpose of this study was to evaluate whether CC-AAbs levels could predict prognosis in CHF patients. A total of 2096 patients with CHF (841 DCM patients and 1255 ICM patients) and 834 control subjects were recruited. CC-AAbs were detected and the relationship between CC-AAbs and patient prognosis was analyzed. During a median follow-up time of 52 months, there were 578 deaths. Of these, sudden cardiac death (SCD) occurred in 102 cases of DCM and 121 cases of ICM. The presence of CC-AAbs in patients was significantly higher than that of controls (bothP<0.001). Multivariate analysis revealed that positive CC-AAbs could predict SCD (HR 3.191, 95% CI 1.598–6.369 for DCM; HR 2.805, 95% CI 1.488–5.288 for ICM) and all-cause mortality (HR 1.733, 95% CI 1.042–2.883 for DCM; HR 2.219, 95% CI 1.461–3.371 for ICM) in CHF patients. A significant association between CC-AAbs and non-SCD (NSCD) was found in ICM patients (HR = 1.887, 95% CI 1.081–3.293). Our results demonstrated that the presence of CC-AAbs was higher in CHF patients versus controls and corresponds to a higher incidence of all-cause death and SCD. Positive CC-AAbs may serve as an independent predictor for SCD and all-cause death in these patients.

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Paradox of self-care gender differences among Italian patients with chronic heart failure: findings from a real-world cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-021966 ◽

2018 ◽

Vol 8 (9) ◽

pp. e021966 ◽

Cited By ~ 10

Author(s):

Federica Dellafiore ◽

Cristina Arrigoni ◽

Francesco Pittella ◽

Gianluca Conte ◽

Arianna Magon ◽

...

Keyword(s):

Heart Failure ◽

Gender Differences ◽

Chronic Heart Failure ◽

Real World ◽

Self Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Caregiver Relationship

AimThe aim of this study was to critically analyse and describe gender differences related to self-care among patients with chronic heart failure (HF).Methods and resultsA monocentric real-world cohort of 346 patients with chronic HF in follow-up was used for this cross-sectional study. We report data related to the cohort’s demographic and clinical characteristics. Self-care was assessed using the Self-Care of Heart Failure Index before patients’ discharge. After bivariate analysis, logistical regression models were used to describe the relationship between gender, self-care behaviours and self-care confidence. While men were found to have more than quadruple the risk of poor self-care than women (OR 4.596; 95% CI 1.075 to 19.650), men were also found to be approximately 60% more likely to have adequate self-care confidence than women (OR 0.412; 95% CI 0.104 to 0.962). Considering that self-care confidence is described as a positive predictor of behaviours, our results suggest a paradox. It is possible that the patient–caregiver relationship mediates the effect of confidence on behaviours. Overall, adequate levels of self-care behaviours are a current issue, ranging 7.6%–18.0%.ConclusionThis study sets the stage for future research where elements of the patient–caregiver relationship ought to be considered to inform the planning of appropriate educational interventions. We recommend routinely measuring patients’ self-care behaviours to guide their follow-up and as a basis for any changes in their daily life behaviours.

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GW25-e4426 Community care follow-up of patients with chronic heart failure 5 years report

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2014.06.1139 ◽

2014 ◽

Vol 64 (16) ◽

pp. C245

Author(s):

Sun Zhigang

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Community Care

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PROGNOSTIC MODEL FOR HOSPITALIZATION PREDICTION DURING THE NEXT 6 MONTHS IN THE ELDERLY WITH CHRONIC HEART FAILURE: DEVELOPMENT, RATIONALE, EVALUATION

Bulletin of Problems Biology and Medicine ◽

10.29254/2077-4214-2021-3-161-149-153 ◽

2021 ◽

Vol 3 (1) ◽

pp. 149

Author(s):

O. O. Khaniukov ◽

O. V. Smolianova

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Prognostic Model ◽

The Elderly

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Quality of life in patients with chronic heart failure and their carers: a 3-year follow-up study assessing hospitalization and mortality

European Journal of Heart Failure ◽

10.1093/eurjhf/hfq114 ◽

2010 ◽

Vol 12 (9) ◽

pp. 1002-1008 ◽

Cited By ~ 91

Author(s):

Javaid Iqbal ◽

Loraine Francis ◽

Janet Reid ◽

Scott Murray ◽

Martin Denvir

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Chronic Heart Failure ◽

Follow Up Study

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Predicting mortality for patients with heart failure beyond oxygen consumption: a prognostic risk score

Journal of Applied Physiology ◽

10.1152/japplphysiol.00326.2021 ◽

2021 ◽

Author(s):

Hanaa Shafiek ◽

Andres Grau ◽

Jaume Pons ◽

Pere Pericas ◽

Xavier Rossello ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Risk Score ◽

Cardiac Transplantation ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Functional Evaluation ◽

Cardiac Events ◽

Ventricular Ejection Fraction

Background: Cardiopulmonary exercise test (CPET) is a crucial tool for the functional evaluation of cardiac patients. We hypothesized that VO2 max and VE/VCO2 slope are not the only parameters of CPET able to predict major cardiac events (mortality or cardiac transplantation urgently or elective). Objectives: We aimed to identify the best CPET predictors of major cardiac events in patients with severe chronic heart failure and to propose an integrated score that could be applied for their prognostic evaluation. Methods: We evaluated 140 patients with chronic heart failure who underwent CPET between 2011 and 2019. Major cardiac events were evaluated during follow-up. Univariate and multivariate logistic regression analysis were applied to study the predictive value of different clinical, echocardiographic and CPET parameters in relation to the major cardiac events. A score was generated and c-statistic was used for the comparisons. Results: Thirty-nine patients (27.9%) died or underwent cardiac transplantation over a median follow-up of 48 months. Five parameters (maximal workload, breathing reserve, left ventricular ejection fraction, diastolic dysfunction and non-idiopathic cardiomyopathy) were used to generate a risk score that had better risk discrimination than NYHA dyspnea scale, VO2 max, VE/VCO2 slope > 35 alone, and combined VO2 max and VE/VCO2 slope (p= 0.009, 0.004, < 0.001 and 0.005 respectively) in predicting major cardiac events. Conclusions: A composite score of CPET and clinical/echocardiographic data is more reliable than the single use of VO2max or combined with VE/VCO2 slope to predict major cardiac events.

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