Comparison Of Clinical Characteristics Between The Elderly And The Non-Elderly Hospitalized Patients With Heart Failure With Reduced Ejection Fraction

Objective:To compare clinical characteristics of patients with chronic heart failure with ejection fraction(HFREF) between the elderly and the non-elderly. To understand deeply the feature of HFREF and improve the level of diagnosis and treatment for HFREF.Methods:The data of hospitalized patients with HFREF from January 1, 2011 to January 1, 2013 at department of Fujian Medical University Union Hosptial were collected. Patients’ general items, NYHA classification, echocardiogram parameters, laboratory tests, etiology, concomitant disease, drug therapy and in-hospital mortality were recorded in detail. According to the patient’s age, patients were divided into the elderly group(≥60 years old)and non-elderly group(<60 years old),the results of the two groups were compared and analyzed.Results:A total of 138 patients were enrolled.There were 84 cases(60.9%)in the elderly group and 54 cases(39.1%) in the non elderly group respectively. The elderly group in-hospital mortality was higher than that in the non-elderly group(3.6% vs 0%, p < 0.05).There was no statistical difference between the two groups in gender, NYHA classification, heart rate, diastolic blood pressure, heart failure drugs usage and hospitalization days(p>0.05). The rate of ischemic heart disease what caused heart failure was higher in the elderly group(45.2% vs 11.1%,p<0.01),while the dilated cardiomyopathy(DCM) was lower than that in the non-elderly group(59.5% vs 85.2%, p<0.01). Patients with hypertension and renal insufficiency were more in the elderly group than that in the non-elderly group(p< 0.05),but the prevalence of pneumonia, diabetes, and atrial fibrillation showed no significant difference between the two groups(p> 0.05). The level of systolic blood pressure and the incidence of lung rale, pleural effusion,lower extremity edema were higher in the elderly groupthan in the non-elderly group(p< 0.05). LVED, LVES, LDL- C, RBC, HB level were lower in the elderly group(p < 0.05) than that in the non-elderly group.The proportion of elderly patients with atrial fibrillation(AF) whose CHA2DS2-VASC score≥2 points was higher than that of the non elderly group(100% vs 68.8%, p < 0.05), but the usage of warfarin was less in elderly group than in the non-elderly group(48.4% vs 81.2%, p < 0.05). Furthermore, patients with stoke in the elderly with HF and AF were more than that in the non-elderly group( p < 0.01).Conclutions:Compared with the non-elderly patients with heart failure, the elderly HFREF patients presented different characteristics with higher in-hospital mortality, higher proportion of ischemic heart disease and lower proportion of dilated cardiomyopathy. The elderly patients showed not only higher prevalence of comorbidities, including hypertension and renal insufficiency,but also higher systolic blood pressure level and more obvious signs.The elderly patients with HF and AF have higher risk for stroke but the usage of anticoagulation therapy was lower.