Risk factors for poor prognosis in elderly patients with chronic heart failure

Introduction . Chronic heart failure (CHF) is an important problem in cardiology, as it often becomes the final stage of cardiovascular diseases. Elderly people make up a significant proportion of patients with CHF. To optimize treatment, it is important to understand the factors affecting the prognosis, as this will help to more accurately assess the risks and develop individual treatment strategies. Aim . To identify prognostic factors for adverse outcome in elderly patients with CHF with preserved ejection fraction. Materials and methods. The study included 95 elderly patients with CHF with preserved ejection fraction. The study was a register, prospective, observational, single-center study. To analyze survival time, Kaplan-Meier curves were constructed, with an assessment of the long rank test. Cox proportional hazards models were used to assess the effect of each factor on the time to an unfavorable outcome. Results . The average age of patients was 81.3 ± 4.2 years, of which 76.8% were women and 23.2% were men. Age is a statistically significant (p = 0.019) factor for unfavorable outcome, with an increase in age by 1 year, the chances of a fatal outcome increase by 16.8%. Patients with functional class (FC) 3 and 4 have a statistically significantly higher risk of death (p = 0.040), 4.5 times higher than the risk in patients with FC 1 and 2. High functional status scores of patients according to the Barthel index and Instrumental Activities of Daily Living scale did not show an association with a reduced risk of adverse outcome in patients with preserved ejection fraction. The use of beta-blockers is associated with a significant (p = 0.02) reduction in the risk of death by 91.1%. Taking RAAS inhibitors is associated with a statistically significant (p = 0.049) 80.0% reduction in the risk of death. Conclusion . A comprehensive assessment of factors affecting the prognosis in individuals with CHF in old age can contribute to improving the effectiveness of treatment and improving the prognosis.