Age, left ventricular ejection fraction, and cause-specific mortality in patients hospitalized for heart failure: insights from a cohort of 2,256 patients
C Bonanad Lozano, E Rodriguez Borja, D Sanchez Espinosa, M Izquierdo, P Lopez-Diez, A Arroyo, G Barreres Martin, F Esteve Claramunt, D Bompart, D Maidana, S E R G I O Garcia-BlasAbstract
Background
The influence of age and left ventricular ejection fraction (LVEF) on cardiovascular (CV) versus non-cardiovascular (non-CV) mortality in heart failure (HF) remains insufficiently defined.
Methods
We evaluated 2,256 HF patients and classified deaths as CV or non-CV. Analyses were stratified by age (<80 vs ≥80 years; detailed ≥80 subgroups) and LVEF (preserved ≥50%, reduced <50%, or missing).
Results
Overall mortality was ~60%. Age did not significantly modify the distribution of CV versus non-CV mortality, and older subgroups consistently showed CV mortality as the predominant cause. LVEF, however, strongly influenced mortality patterns. Patients with preserved LVEF exhibited a stable CV/non-CV distribution across ages. Those with reduced LVEF showed a higher proportion of CV mortality in individuals ≥80 years. Patients without recorded LVEF displayed a distinct profile: non-CV mortality predominated in younger patients, whereas CV mortality dominated in the elderly.
Conclusion
Age alone does not substantially shift the cause of death in HF. LVEF is the key determinant of mortality pattern, especially in older adults. Missing LVEF identifies a heterogeneous, high-risk group that warrants further study.For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.