title: Predictors of clinical outcomes in elderly patients with heart failure.
abstract: OBJECTIVE
  Heart failure (HF) in the elderly carries a poor prognosis. We used the SENIORS dataset of elderly HF patients aged ≥70 years in order to develop a risk model for this population.
  
  
  RESULTS
  The SENIORS trial evaluated the effects of nebivolol and enrolled 2128 patients ≥70 years with HF (ejection fraction ≤35%, or recent HF admission). We randomly selected 1400 patients from the full dataset to produce a derivation cohort and the remaining 728 patients were used as a validation cohort. Baseline variables were entered into a bootstrap model with 200 iterations to determine their association with two outcomes, the composite of all-cause mortality or cardiovascular hospitalization, or all-cause mortality alone. Variables retaining a significant association with these outcomes in a multivariate model were used to develop a risk prediction score tested in the validation cohort. Five factors were associated with increased risk of both outcomes in the multivariate model: higher New York Heart Association class, higher uric acid level, lower body mass index, prior myocardial infarction, and larger left atrial (LA) dimension. For the composite outcome, peripheral arterial disease, years with heart failure, right bundle branch block, diabetes mellitus, and orthopnoea were also retained. For all-cause mortality, creatinine, 6 min walk test distance, coronary artery disease, and age were retained.
  
  
  CONCLUSIONS
  In addition to conventional prognostic markers, uric acid and LA dimension appear to be important novel risk prediction markers in elderly patients with heart failure, and could be useful in guiding management.
authors: University of Alcala, Madrid, Spain. luis.manzano@uah.es
authors: Luis
authors: L
authors: Manzano
authors: Daphne
authors: D
authors: Babalis
authors: Michael
authors: M
authors: Roughton
authors: Marcelo
authors: M
authors: Shibata
authors: Stefan D
authors: SD
authors: Anker
authors: Stefano
authors: S
authors: Ghio
authors: Dirk J
authors: DJ
authors: van Veldhuisen
authors: Alain
authors: A
authors: Cohen-Solal
authors: Andrew J
authors: AJ
authors: Coats
authors: Philip P A
authors: PP
authors: Poole-Wilson
authors: Marcus D
authors: MD
authors: Flather
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002037:Bundle-Branch Block / Q000453:epidemiology; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D005260:Female; D006325:Heart Atria / Q000473:pathology; D006333:Heart Failure / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D018570:Risk Assessment; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood
chemical_list: D014527:Uric Acid; D003404:Creatinine