Takeaway
Frailty in patients with heart failure with reduced ejection fraction (HFrEF) was associated with sub-optimal medical treatment.
Frail patients with chronic heart failure (CHF) experienced a far higher rate of death and hospitalisations, but whether frail or not, many events were non-cardiovascular (non-CV).
Why this matters
Findings highlight the need for a holistic and patient-centred approach to address the various healthcare needs of patients with CHF, especially in those living with frailty.
Study design
Study of 467 ambulatory patients with CHF (67% male; median age, 76 years; median N-terminal pro-B-type natriuretic peptide, 1156 ng/L).
Frailty was assessed using the clinical frailty scale (CFS). Those with CFS >4 were classified as frail.
Association between frailty, treatments, hospitalisation and death in patients with CHF was evaluated.
Funding: None.
Key results
Overall, 206 (44%) patients were frail.
Of 291 patients with HFrEF, 117 (40%) frail patients were more likely to receive sub-optimal treatment and less likely to be prescribed angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (frail: 25% vs non-frail: 4%), beta-blockers (16% vs 8%) and mineralocorticoid receptor antagonists (50% vs 41%).
By 1-year follow-up, there were 56 deaths, of which 46 (82%) deaths occurred in frail patients.
In frail patients who died, the cause was non-CV in 43% vs 50% amongst non-frail patients (P=.71).
By 1-year follow-up, there were 322 hospitalisations, of which 215 events occurred in 96 (47%) frail patients and 107 events in 54 (21%) non-frail patients.
In frail patients, 64% of hospitalisations were because of non-CV causes vs 57% in non-frail patients (P=.25).
Limitations
Limited sample size.
Single-centre study.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Sarfaroj Khan. Impact of Frailty on Treatment, Hospitalisation and Death in Patients With Chronic Heart Failure - Medscape - Jan 08, 2021.
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