Clinical determinants of long-term mortality in elderly patients with heart disease

D. Acanfora, C. Crisci, C. Rengo, D. F. Vitale, G. Furgi, C. Picone, A. Papa, F. Rengo

Research output: Contribution to journalArticle

Abstract

To determine which of the many clinical parameters routinely collected influence mortality in patients with low left ventricular ejection fraction (LVEF) (<45% at radionuclide ventriculography), 128 elderly patients (mean age 79 ± 3 years) with various heart diseases were prospectively followed for 3 years. Twenty-eight-percent had coronary heart disease, 16% hypertensive heart disease, 7% valvular heart disease. The remaining 62 patients (48%) made up a group comprising patients with primitive cardiomyopathy, cor pulmonary with no evidence of coronary heart disease, valvular disease or hypertensive heart disease. Thirty-four-percent of all patients were classified as having congestive heart failure (CHF). Age, sex and 37 clinical variables were analyzed using a Cox proportional model. Forty-four patients died, 36 (82%) of sudden cardiac death. Ten characteristics at study entry predicted an increased mortality risk: S3 gallop, number of clinical signs ≥ 3, LVEF ≤ 25%, New York Heart Association (NYHA) class ≥ III, dyspnea, digoxin treatment, rales, number of symptoms ≥ 4, asthenia, associated pulmonary disease. Long-term survival of very elderly patients with low ejection fraction is related to the functional capacity, the severity of symptoms and the number of clinical signs. Moreover a LVEF ≤ 25% selects a subgroup of patients at higher risk. Our results suggest that these variables may influence the long-term survival of elderly patients with heart disease. Further studies with a greater number of patients are necessary to better delineate the prognostic value of the clinical and instrumental variables routinely collected in these patients.

Original languageEnglish
Pages (from-to)233-240
Number of pages8
JournalArchives of Gerontology and Geriatrics
Volume21
Issue number3
DOIs
Publication statusPublished - 1995

Fingerprint

heart disease
Heart Diseases
mortality
determinants
Mortality
Stroke Volume
Disease
Coronary Disease
Radionuclide Ventriculography
Asthenia
Heart Valve Diseases
Survival
Digoxin
Sudden Cardiac Death
Respiratory Sounds
death
Cardiomyopathies
Proportional Hazards Models
Dyspnea
Lung Diseases

Keywords

  • Congestive heart failure
  • Elderly
  • Heart disease
  • Long-term mortality

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology
  • Gerontology
  • Health(social science)
  • Medicine(all)

Cite this

Clinical determinants of long-term mortality in elderly patients with heart disease. / Acanfora, D.; Crisci, C.; Rengo, C.; Vitale, D. F.; Furgi, G.; Picone, C.; Papa, A.; Rengo, F.

In: Archives of Gerontology and Geriatrics, Vol. 21, No. 3, 1995, p. 233-240.

Research output: Contribution to journalArticle

Acanfora, D, Crisci, C, Rengo, C, Vitale, DF, Furgi, G, Picone, C, Papa, A & Rengo, F 1995, 'Clinical determinants of long-term mortality in elderly patients with heart disease', Archives of Gerontology and Geriatrics, vol. 21, no. 3, pp. 233-240. https://doi.org/10.1016/0167-4943(95)00658-8
Acanfora, D. ; Crisci, C. ; Rengo, C. ; Vitale, D. F. ; Furgi, G. ; Picone, C. ; Papa, A. ; Rengo, F. / Clinical determinants of long-term mortality in elderly patients with heart disease. In: Archives of Gerontology and Geriatrics. 1995 ; Vol. 21, No. 3. pp. 233-240.
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