Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Age-Related Characteristics and Outcomes of Patients With Heart Failure With Preserved Ejection Fraction

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Natural History of Subclinical Atrial Fibrillation Detected by Implanted Loop Recorders

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Effects of Interatrial Shunt on Pulmonary Vascular Function in Heart Failure With Preserved Ejection Fraction

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Reply: Enterococcus faecalis Infective Endocarditis

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Direct Current Cardioversion of Atrial Fibrillation in Patients With Left Atrial Appendage Occlusion Devices

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Regional variation in out-of-hospital cardiac arrest: incidence and survival - a nationwide study of regions in Denmark

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Genome-wide association and Mendelian randomisation analysis provide insights into the pathogenesis of heart failure

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Time in therapeutic range and risk of thromboembolism and bleeding in patients with a mechanical heart valve prosthesis

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Jasper Tromp
  • Li Shen
  • Pardeep S Jhund
  • Inder S Anand
  • Peter E Carson
  • Akshay S Desai
  • Christopher B Granger
  • Michel Komajda
  • Robert S McKelvie
  • Marc A Pfeffer
  • Scott D Solomon
  • Lars Køber
  • Karl Swedberg
  • Michael R Zile
  • Bertram Pitt
  • Carolyn S P Lam
  • John J V McMurray
View graph of relations

BACKGROUND: Although heart failure with preserved ejection fraction (HFpEF) is considered a disease of the elderly, younger patients are not spared from this syndrome.

OBJECTIVES: This study therefore investigated the associations among age, clinical characteristics, and outcomes in patients with HFpEF.

METHODS: Using data on patients with left ventricular ejection fraction ≥45% from 3 large HFpEF trials (TOPCAT [Aldosterone Antagonist Therapy for Adults With Heart Failure and Preserved Systolic Function], I-PRESERVE [Irbesartan in Heart Failure With Preserved Systolic Function], and CHARM Preserved [Candesartan Cilexetil in Heart Failure Assessment of Reduction in Mortality and Morbidity]), patients were categorized according to age: ≤55 years (n = 522), 56 to 64 years (n = 1,679), 65 to 74 years (n = 3,405), 75 to 84 years (n = 2,464), and ≥85 years (n = 398). This study compared clinical and echocardiographic characteristics, as well as mortality and hospitalization rates, mode of death, and quality of life across age categories.

RESULTS: Younger patients (age ≤55 years) with HFpEF were more often obese, nonwhite men, whereas older patients with HFpEF were more often white women with a higher prevalence of atrial fibrillation, hypertension, and chronic kidney disease (eGFR <60 ml/min/1.73 m2). Despite fewer comorbidities, younger patients had worse quality of life compared with older patients (age ≥85 years). Compared with patients age ≤55 years, patients age ≥85 years had higher mortality (hazard ratio: 6.9; 95% confidence interval: 4.2 to 11.4). However, among patients who died, sudden death was, proportionally, the most common mode of death (p < 0.001) in patients age ≤55 years. In contrast, older patients (age ≥85 years) died more often from noncardiovascular causes (34% vs. 20% in patients age ≤55 years; p < 0.001).

CONCLUSIONS: Compared with the elderly, younger patients with HFpEF were less likely to be white, were more frequently obese men, and died more often of cardiovascular causes, particularly sudden death. In contrast, elderly patients with HFpEF had more comorbidities and died more often from noncardiovascular causes. (Aldosterone Antagonist Therapy for Adults With Heart Failure and Preserved Systolic Function [TOPCAT]; NCT00094302; Irbesartan in Heart Failure With Preserved Systolic Function [I-PRESERVE]; NCT00095238; Candesartan Cilexetil in Heart Failure Assessment of Reduction in Mortality and Morbidity [CHARM Preserved]; NCT00634712).

Original languageEnglish
JournalJournal of the American College of Cardiology
Volume74
Issue number5
Pages (from-to)601-612
Number of pages12
ISSN0735-1097
DOIs
Publication statusPublished - 6 Aug 2019

    Research areas

  • heart failure, HFpEF, race, young

ID: 58252095