Ege Tıp Dergisi

Öz

Objective: This study aims to identify the comorbidities, the usage rates of heart failure treatments that improve survival, and the achievement of target doses in elderly patients followed up at the Heart Failure Outpatient Clinic of the Cardiology Department at Ege University Faculty of Medicine. Additionally, the study seeks to compare the differences in primary and secondary outcomes between the elderly and younger patient groups, and to investigate the impact of medical treatment doses on reaching the primary endpoint in the elderly group.
Method: The study included 1624 patients diagnosed with heart failure and followed up in the outpatient clinic. Clinical data of the patients were obtained from patient files, electronic records, and, when necessary, through phone interviews. The elderly heart failure group was defined as patients diagnosed at or above the 75th percentile age. Patients were evaluated based on their use and doses of medical treatment.
Results: Among the elderly heart failure patients, 39.2% were classified as NYHA functional class III, and 9.2% as NYHA functional class IV. Systolic and diastolic blood pressures were found to be lower in the elderly group compared to the younger group. Comorbid conditions (hypertension, diabetes mellitus, hyperlipidemia, COPD) were more prevalent in the elderly group. The rates of achieving target doses for beta-blockers and ACE inhibitors/ARBs were lower in the elderly group. The rate of reaching the primary endpoint was 35% in the elderly group, compared to 25.2% in the younger group. Cox regression analyses showed that an increase in left ventricular ejection fraction had a positive impact on survival.
Conclusion: The burden of comorbid diseases is higher in elderly heart failure patients, which negatively affects the treatment process. Achieving target doses of medical treatments improves survival, emphasizing the importance of adherence to therapy.