Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing 100853, China.
J Geriatr Cardiol. 2012 Dec;9(4):355-60. doi: 10.3724/SP.J.1263.2012.04121.
To evaluate the prognostic value of chronic kidney disease (CKD) in elderly Chinese patients with chronic heart failure (CHF).
The study consisted of 327 elderly patients with CHF. All-cause mortality was chosen as an endpoint over the median follow-up period of 345 days. Cox regression analysis was used to identify the risk factors of mortality.
The median age of the entire cohort was 85 years (60-100 years). The mortality for 168 elderly patients with CHF and CKD (51.4% of entire cohort) was 39.9% (67 deaths), which was higher than the mortality for CHF patients without CKD [25.2% (40/159 deaths)] and the mortality for entire cohort with CHF [32.7% (107/327 deaths)]. The Cox regression analysis showed that old age [hazard ratio (HR): 1.033; 95% confidence interval (95% CI): 1.004-1.064], CKD (HR: 1.705; 95% CI: 1.132-2.567), CHF New York Heart Association (NYHA) class IV (HR: 1.913; 95% CI: 1.284-2.851), acute myocardial infarction (AMI) (HR: 1.696; 95% CI: 1.036-2.777), elevated resting heart rate (HR: 1.021; 95% CI: 1.009-1.033), and decreased plasma albumin (HR: 0.883; 95% CI: 0.843-0.925) were independent risk factors of mortality for elderly patients with CHF.
CKD was an independent risk factor of mortality for elderly Chinese patients with CHF.
评估慢性肾脏病（CKD）对老年慢性心力衰竭（CHF）患者的预后价值。
该研究纳入 327 例老年 CHF 患者。全因死亡率被选为中位随访 345 天的终点。Cox 回归分析用于确定死亡的危险因素。
整个队列的中位年龄为 85 岁（60-100 岁）。168 例 CHF 合并 CKD 患者（整个队列的 51.4%）的死亡率为 39.9%（67 例死亡），高于无 CKD 的 CHF 患者[25.2%（40/159 例死亡）]和整个 CHF 队列的死亡率[32.7%（107/327 例死亡）]。Cox 回归分析显示，年龄较大（风险比 [HR]：1.033；95%置信区间 [95%CI]：1.004-1.064）、CKD（HR：1.705；95%CI：1.132-2.567）、CHF 纽约心脏协会（NYHA）分级 IV（HR：1.913；95%CI：1.284-2.851）、急性心肌梗死（AMI）（HR：1.696；95%CI：1.036-2.777）、静息心率升高（HR：1.021；95%CI：1.009-1.033）和血浆白蛋白降低（HR：0.883；95%CI：0.843-0.925）是老年 CHF 患者死亡的独立危险因素。
CKD 是老年中国 CHF 患者死亡的独立危险因素。
