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Segmental Kinetic Disturbances: A Poor Predictor of Coronary Artery Disease in Very Elderly Patients with Heart Failure
Session:
SESSÃO DE POSTERS 10 - GERIATRIA CARDIOVASCULAR: MOSTRA-ME OS DADOS!
Speaker:
José Luís Ferraro
Congress:
CPC 2025
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.3 Chronic Heart Failure – Diagnostic Methods
Session Type:
Cartazes
FP Number:
---
Authors:
José Luís Ferraro; Mauro Moreira; Ana Rodrigo Costa; Inês G. Campos; Rafaela G. Lopes; Joel Ponte Monteiro; Inês Almeida; Carla Almeida; Aurora Andrade
Abstract
<p style="text-align:justify"><span style="font-family:Verdana,Geneva,sans-serif"><span style="font-size:12pt"><strong>Background:</strong> Very elderly patients with heart failure (HF) is a growing population that exhibit distinct clinical characteristics and cardiovascular phenotypes, highlighting the need for personalized approaches in management. The aim of this study was to compare clinical characteristics between very elderly (≥80 years) and elderly (65-80 years) patients with HF.</span></span></p> <p style="text-align:justify"><span style="font-family:Verdana,Geneva,sans-serif"><span style="font-size:12pt"><strong>Methods:</strong> A retrospective single-center analysis <span style="font-size:11.0pt"><span style="color:black">of patients admitted for HF</span></span> <span style="font-size:11.0pt"><span style="color:black">throughout 2022, </span></span>included 265 patients. There were divided in two groups: very elderly (n=76) and elderly (n=104). A statistical analysis was performed to compare baseline characteristics, biomarkers, coronary anatomy, and outcomes between groups. A p-value of <0.05 was considered statistically significant. </span></span></p> <p style="text-align:justify"><span style="font-family:Verdana,Geneva,sans-serif"><span style="font-size:12pt"><strong>Results:</strong> The mean age of very elderly and elderly group was 85 ± 3.3 and 73 ± 4.5 years, respectively. The median follow-up period was 1.5 years. Very elderly patients were predominantly revascularized surgically in the past and elderly patients were predominantly revascularized percutaneously (p=0.003). Complete revascularization was significantly more frequent in very elderly patients compared to elderly patients (87.5% vs. 43.5%, p=0.031). Valvular etiology was more frequent in the very elderly group, with severe aortic stenosis being the most common condition (34.7% vs. 15.4%, p=0.003). Very elderly patients showed a predominance of heart failure with preserved ejection fraction, elderly patients predominantly had heart failure with reduced ejection fraction (p=0.011). 49.3% of very elderly patients and 29.8% of elderly patients did not have segmental kinetic disturbances (p=0.033). There were no significant differences between groups regarding invasive coronary angiography during hospitalization and detection of coronary arterial disease detection or progression. Logistic regression analysis showed that SKD did not significantly predict CAD in very elderly patients (p=0.705, OR=0.859). </span></span></p> <p style="text-align:justify"><span style="font-family:Verdana,Geneva,sans-serif"><span style="font-size:12pt"><strong>Conclusion:</strong> Very elderly and elderly patients have distinct cardiovascular profiles. Despite fewer segmental kinetic disturbances in the very elderly group, similar rates of invasive coronary angiography during hospitalization and disease progression were observed. This raises the possibility that segmental kinetic disturbances may not be a fully reliable primary factor in decision-making for catheterization in very elderly patients. Further studies are needed to identify additional predictors for catheterization in this population.</span></span></p>
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