PCV76 EFFECTS OF AGE ON THE ASSOCIATION BETWEEN COMORBIDITIES AND MORTALITY IN ADULTS WITH HEART FAILURE

Abstract

Age and comorbidities are independent risk factors for mortality in adults with heart failure (HF). This study explored the modifying effect of age on the association between comorbidities and all-cause mortality among a national sample of adults with HF. This was a retrospective cohort study based on public-use data of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010, on adults who self-reported as having been diagnosed with HF. The outcome of the study was all-cause mortality. The primary independent variable was type of comorbidity (non-cardiovascular, cardiovascular and mixed). Descriptive statistics were used to describe the relationship between comorbidity and variables of interest. Age-stratified multivariate Cox Proportional Hazards models were used to assess the association of comorbidity with all-cause mortality overall and by age strata (≤60, 61–70,71–80, and >80 years old). The study included 926 HF subjects: mean age was 68 years, and 42% died during follow-up. The age-specific all-cause mortality rates of subjects ≤60, 61 – 70, 71 – 80, and > 80 years of age, were 20%, 28%, 48% and 82% respectively. In the overall cohort, subjects with non-cardiovascular and mixed comorbidities had a higher risk of all-cause mortality than those with cardiovascular comorbidities (HR=2.0,95%CI=1.2-3.2 and HR=1.6, 95% CI=1.1-2.2 respectively). The risk of all-cause mortality for mixed comorbidities compared to cardiovascular comorbidities was higher for subjects 61-70 years of age (HR=5.4, 95% CI=1.4-19.7), but lower for subjects >80 years of age (HR=0.5,95%CI=0.4-0.8). We found an association of higher risk of all-cause mortality with mixed and non-cardiovascular comorbidities compared to cardiovascular comorbidities in different age-groups. These findings may help to inform clinicians and health care providers on the management of HF patients with comorbidities and of different age groups.