Prognostic impact of systemic inflammatory diseases in elderly patients with congestive heart failure.
QJM
; 107(2): 131-8, 2014 Feb.
Article
in En
| MEDLINE
| ID: mdl-24131549
ABSTRACT
BACKGROUND AND AIMS:
Inflammation is part of the pathophysiology of congestive heart failure (CHF). However, little is known about the impact of the presence of systemic inflammatory disease (SID), defined as inflammatory syndrome with constitutional symptoms and involvement of at least two organs as co-morbidity on the clinical course and prognosis of patients with CHF. METHODS ANDRESULTS:
This is an analysis of all 622 patients included in TIME-CHF. After an 18 months follow-up, outcomes of patients with and without SID were compared. Primary endpoint was all-cause hospitalization free survival. Secondary endpoints were overall survival and CHF hospitalization free survival. At baseline, 38 patients had history of SID (6.1%). These patients had higher N-terminal pro brain natriuretic peptide and worse renal function than patients without SID. SID was a risk factor for adverse outcome [primary endpoint hazard ratio (HR) = 1.73 (95% confidence interval 1.18-2.55, P = 0.005); survival HR = 2.60 (1.49-4.55, P = 0.001); CHF hospitalization free survival HR = 2.3 (1.45-3.65, P < 0.001)]. In multivariate models, SID remained the strongest independent risk factor for survival and CHF hospitalization free survival.CONCLUSION:
In elderly patients with CHF, SID is independently accompanied with adverse outcome. Given the increasing prevalence of SID in the elderly population, these findings are clinically important for both risk stratification and patient management.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Heart Failure
/
Inflammation
Type of study:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
QJM
Journal subject:
MEDICINA
Year:
2014
Document type:
Article
Affiliation country:
Suiza