Abstract 1630: Predictors of Clinical Outcomes in Elderly Patients With Chronic Heart Failure: Results From the SENIORS Sstudy
Purpose There is limited evidence on predictors of mortality and morbidity in ambulatory elderly patients with heart failure (HF). We analyzed the SENIORS dataset to determine prognostic factors in this population.
Methods The SENIORS trial enrolled 2128 patients ≥70 years with chronic HF (ejection fraction≥35% or recent admission with heart failure) and followed them for about 2 years. We randomly selected 1400 patients for a derivation dataset and 728 for a validation dataset. Thirty baseline variables were entered into a bootstrap model with 200 iterations to determine their association with two clinical outcomes. Variables retaining a significant association in a multivariate model were used to develop a risk prediction score which was tested in the validation cohort. The primary outcome was a composite of death or cardiovascular (CV) hospitalization and the secondary outcome was all cause mortality.
Results Five factors were associated with a higher risk for both outcomes: higher NYHA class, higher uric acid level, lower body mass index (BMI), prior myocardial infarction (MI) and larger left atrial (LA) dimension. For the composite outcome, peripheral arterial disease (PAD) and years with heart failure were also retained, and for all cause mortality female gender (lower risk) and shorter 6 minute walk test (6MWT) distance were retained. There was good agreement between the derivation and validation cohort for prediction of risk.
Conclusions Conventional risk markers including age, anemia, renal dysfunction, diabetes and ejection fraction appear less relevant in an elderly HF population while uric acid and left atrial dimension appear to be important novel risk markers.