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 journalArticlepeer-review

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

Keywords

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

ASJC Scopus subject areas

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

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