Factors Affecting The Long-term Prognosis Of Elderly Patients With Chronic Systolic Heart Failure

Background In China, with the rapid growth of the aging of the population, a huge base of people at risk of cardiovascular disease. Chronic heart failure (CHF) has become the major issue that endangers the health of the elderly population. American College of Cardiology-stroke2008annual reported that the incidence of heart failure (CHF) increased with age, and heart failure (HF) incidence was10cases per thousand people over the age of65in the United States. The Framingham Heart Study showed that in the45-94age group, the age for each additional10years, the incidence of heart failure increased by about1times. Due to conventional drug treatment is not ideal for elderly patients with heart failure, an increase in adverse reactions, as well as often associated with other organ or tissue dysfunction, thus affecting the prognosis. Therefore to make an accurate assessment of the prognosis of elderly patients with heart failure, to intervene the heart process timely, to choose the right treatment program, has much importance in delaying the development of heart failure disease, improving the patient’s quality of life, and improving the survival rate.Objective This study analyzes elderly patients with chronic systolic heart failure in patients with long-term survival and influencing factors, providing a scientific basis to improve survival, and to develop control strategies.Methods This study was a single-center retrospective study.316cases confirmed by the echocardiographic left ventricular ejection fraction (LVEF)≤45%of ischemic cardiomyopathy and dilated cardiomyopathy in elderly patients divided into LVEF≤35%(N=151) and LVEF36-45%(N=165) the two groups were followed up. The study endpoint was all-cause mortality. Survival time as the horizontal axis, the survival rate for the vertical axis drawing survival curves (Kaplan-Meier), used to describe the process of its existence. And two survival curves level direct comparison between the two groups to survive the process. Long-rank test for each indicator single factor statistical analysis, univariate analyzes were selected statistically significant variables the multiple stepwise COX model survival analysis and evaluation of the prognosis of patients with risk factors.Results A total of112patients died during follow-up (median follow-up time of31months). LVEF≤35%of patients with the disease, all-cause mortality was49%, while LVEF3645%of patients with all-cause mortality was23%(P=0.000). Long-rank test analysis showed that age, body mass index, hemoglobin, glomerular filtration rate, uric acid, sodium, left ventricular end-diastolic diameter (LVEDD), LVEF, Angiotensin-converting enzyme inhibitors (ACEI)/Angiotensin receptor blockers (ARB), beta blockers and aldosterone receptor antagonist use two groups of survival rates was statistically significant (P<0.05),A Cox regression analysis showed that the predictors of all-cause mortality were age, BMI, uric acid and LVEF in elderly patients with chronic systolic heart failure(HR were1.050,0.573,1.002,0.968,95%confidence interval were1.019-1.083,0.435-0.756,1.001-1.003.0.944-0.992, P<0.05).Conclusion Age, low BMI, high uric acid, low LVEF are independent risk factor affect the survival of elderly patients with heart failure. Elderly patients with chronic systolic heart failure have a poor prognosis, especially for patients with LVEF≤35%.