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Younger HF patients exhibit markedly different clinical profile
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Younger patients with HF exhibit marked differences in presentation and outcomes compared with older patients. Such differences include less common clinical and radiological signs of HF, but significantly more impaired quality of life, researchers reported.
Using data collected from the multicenter CHARM study database, researchers categorized patients with chronic HF according to age: 20 to 39 years (n=120); 40 to 49 years (n=538); 50 to 59 years (n=1,527); 60 to 69 years (n=2,395); and 70 years or older (n=3,019).
“Few studies have focused on young and very young adults with HF,” researchers wrote.
Patients aged 20 to 39 years were significantly less likely to have comorbidities, including angina, atrial fibrillation, diabetes, hypertension, MI, stroke and prior coronary revascularization (P<.0001 for all). The youngest patients also were less likely than the oldest patients to indicate adherence to medication (24% nonadherence vs. 7%; P=.001) and dietary restrictions (21% nonadherence vs. 9%; P=.002).
Rates of hospitalization due to HF after randomization differed significantly according to age, with a rate of 24% in the youngest group, 15% in patients aged 40 to 59 years, 22% in patients aged 60 to 69 years and 28% in those aged at least 70 years (P<.0001). While hospitalized, patients in the youngest group were less likely to exhibit clinical or radiological signs of HF.
Patients aged 20 to 39 years had the lowest all-cause mortality rate at 3 years (12%), but also had worse health-related quality of life than the other groups, as indicated by responses to the Minnesota Living with Heart Failure questionnaire (P<.0001). Multivariate analysis indicated significantly reduced risk for all-cause mortality among patients younger than 60 years compared with those aged 60 to 69 years, with an HR of 0.6 (95% CI, 0.36-1) for those younger than 40 years, 0.63 (95% CI, 0.5-0.81) for those aged 40 to 49 years and 0.64 (95% CI, 0.54-0.75) for those aged 50 to 59 years. The risk for CV-related mortality was not significantly lower among patients younger than 40 years compared with the oldest age group.
Disclosure: See the full study for a list of relevant financial disclosures.
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