title: Contemporary management of octogenarians hospitalized for heart failure in Europe: Euro Heart Failure Survey II.
abstract: OBJECTIVE
  International guidelines are frequently not implemented in the elderly population with heart failure (HF). This study determined the management of octogenarians with HF enrolled in Euro Heart Failure Survey II (EHFS II) (2004-05).
  
  
  RESULTS
  We compared the clinical profile, 12 month outcomes, and management modalities between 741 octogenarians (median age 83.7 years) and 2836 younger patients (median age 68.4 years) hospitalized for acute/decompensated HF. Management modalities were also compared with those observed in EHFS I (2000-01). Female gender, new onset HF (de novo), hypertension, atrial fibrillation, co-morbidities, disabilities, and low quality of life were more common in the elderly (all P < 0.001). Mortality rates during hospital stay and during 12 months after discharge were increased in octogenarians (10.7 vs. 5.6% and 28.4 vs. 18.5%, P < 0.001). Underuse and underdosage of medications recommended for HF were observed in the elderly. However, a significant improvement was observed when compared with EHFS I both in the overall HF octogenarian population and in the subgroup with ejection fraction < or =45% for prescription rates of ACE-I/ARBs, beta-blockers, and aldosterone antagonists at discharge (82 vs. 71%; 56 vs. 29%; 54 vs. 18.5%, respectively, all P < 0.01), as well as for recommended combinations and dosage. Prescription rates remained stable for 12 months after discharge in survivors.
  
  
  CONCLUSIONS
  Our study confirms that the contemporary management of very elderly patients with HF remains suboptimal but that the situation is improving.
authors.affiliation: AP-HP, Department of Cardiology, Pitie Salpetriere Hospital, University Pierre et Marie Curie-Paris 6, Paris, France. michel.komajda@psl.aphp.fr
authors.forename: Michel
authors.initials: M
authors.lastname: Komajda
authors.forename: Olivier
authors.initials: O
authors.lastname: Hanon
authors.forename: Matthias
authors.initials: M
authors.lastname: Hochadel
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Lopez-Sendon
authors.forename: Ferenc
authors.initials: F
authors.lastname: Follath
authors.forename: Piotr
authors.initials: P
authors.lastname: Ponikowski
authors.forename: Veli-Pekka
authors.initials: VP
authors.lastname: Harjola
authors.forename: Helmut
authors.initials: H
authors.lastname: Drexler
authors.forename: Kenneth
authors.initials: K
authors.lastname: Dickstein
authors.forename: Luigi
authors.initials: L
authors.lastname: Tavazzi
authors.forename: Markku
authors.initials: M
authors.lastname: Nieminen
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D015331:Cohort Studies; D004232:Diuretics / Q000627:therapeutic use; D005060:Europe / Q000453:epidemiology; D005260:Female; D006299:Health Services for the Aged / Q000592:standards*; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D002121:Calcium Channel Blockers; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists