Mortality High for Moderate, Severe Heart Failure Patients

Presence of one or more risk factors linked to increased hazard ratio for all-cause mortality

MONDAY, Dec. 9. 2013 (HealthDay News) -- For patients aged 80 years and younger with moderate or severe heart failure, mortality is mainly associated with heart failure and its comorbidities, according to a study published online Nov. 6 in the Journal of the American College of Cardiology.

Tonje Thorvaldsen, M.D., from the Karolinska Institutet in Stockholm, and colleagues assessed observed and expected all-cause mortality using data from the Swedish Heart Failure Registry for 10,062 patients with New York Heart Association (NYHA) III-IV heart failure and ejection fraction <40 percent. Five pre-specified risk factors (systolic blood pressure ≤ 90 mm Hg; creatinine ≥160 µmol/L; hemoglobin ≤120 g/L; no renin-angiotensin system antagonist; and no β-blocker) were assessed as potential triggers for referral to an advanced heart failure center.

The researchers found that for those with NYHA III-IV, the one-year observed versus expected survival was 90 versus 99 percent for those aged ≤65 years; 79 versus 97 percent for those aged 66 to 80 years; and 61 versus 89 percent for those aged >80 years. The presence of one, two, or three to five of these risk factors conferred an independent hazard ratio for all-cause mortality in those ≤80 years of 1.40, 2.30 and 4.07, and one-year survival of 79, 60, and 39 percent, respectively (P < 0.001).

"These patients may benefit from referral to an advanced heart failure center," the authors write.

Two authors disclosed financial ties to the medical device industry.

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