心力衰竭的八代人生存率提高:来自国家推中心的15年队列研究
Viana Copeland1, Boris Fishman1, Assi Milwidsky1
1The Olga and Lev Leviev Heart Center at Sheba Medical Center, Ramat Gan, Israel; The Faculty of Medical and Health Sciences, Tel-Aviv University, Israel.
JACC. Advances
|October 30, 2025
概括
80岁及以上的老年心力衰竭 (HF) 患者的死亡风险在15年内显著下降. 这种改善在心力衰竭中特别显著,其中保留了喷射分数 (HFpEF) 和非脆弱个体.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 公共卫生 公共卫生
背景情况:
- 八代人 (年龄≥80岁) 是一个相当大的心力衰竭 (HF) 患者群体,但在临床试验中代表性不足.
- 了解这一人口群体的死亡率趋势对于改善护理至关重要.
研究的目的:
- 评估2009年至2024年心力衰竭 (HF) 的80岁以上人群死亡率趋势.
- 确定影响这一老年人群生存的因素.
主要方法:
- 在第三级医疗中心对32,892名HF患者的回顾性分析.
- 卡普兰-梅尔生存分析和考克斯回归,按年龄分层 (八分生与非八分生),时间段,HF类型 (HFpEF与HFrEF) 和脆弱性.
- 主要结局:全因死亡率.
主要成果:
- 五年死亡率在八十岁的人群中为69%,而非八十岁的人群中为37% (P < 0.001).
- 经过调整的死亡危险比率 (HRs) 对于八十岁的人来说,随着时间的推移而下降 (早期期HR:2.1;后期HR:1.6;P的相互作用<0.001).
- 死亡率HR在HFpEF患者 (相互作用P<0.001) 和非脆弱患者中下降,但在HFrEF患者中没有下降.
结论:
- 15年来,八十多岁的HF患者的死亡风险有所下降.
- 改善在心力衰竭中最显著,其中保留了喷射分数 (HFpEF) 和非脆弱的患者.
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