Clinical characteristics and one-year survival in heart failure patients more than 85 years of age compared with younger.

Background: Heart failure (HF) is frequent in elderly patients, but few studies have focused on patients older than 84 years. The aim of this study was to evaluate major comorbidities and 1-year survival in HF patients aged ≥85 years compared with younger age groups.

Methods: Patients included in a prospective national registry of HF (RICA) were evaluated. Sociodemographic data, Charlson comorbidity index, cognitive status, basal functional status, body mass index, NYHA functional class, and left ventricle ejection fraction (LVEF) were recorded. Patients aged ≥85 years were compared with the rest using the Cox regression model to detect independent predictive factors of 1-year survival.

Results: Of the 1172 patients included, 224 (19%) were aged over 84 years-old, mostly women, with hypertensive heart disease (46%, p<0.001) and preserved LVEF (68.7%; p<0.001). Diabetes (p<0.001), dyslipidemia (p=0.03) and obesity (p<0.001) were less prevalent in this group of patients. One-year mortality in the oldest old patients was 26.3%, which was higher than the rest (p<0.001). By multivariable analysis, a higher NYHA functional class (p=0.038), anemia (p=0.037), absence of obesity (p=0.002), and a worse functional status (p=0.049) were related to a worse 1-year survival in the oldest HF patients.

Conclusions: The oldest old HF patients have differential characteristics with lower prevalence of diabetes, dyslipidemia and obesity and a lower 1-year survival. Independent factors related to a worse 1-year survival in the oldest age group were a higher NYHA class, a worse functional status, presence of anemia and absence of obesity.