Younger Age Offers No Protection From HFrEF Deaths

METHODOLOGY:

  • Researchers conducted an observational cohort study using linked Danish registries to examine how age affected the risk for excess mortality in patients aged 40-85 years with HFrEF.
  • They included 5425 patients with a left ventricular ejection fraction of 40% or less who underwent coronary angiography for suspected cardiomyopathy between 2010 and 2021. Patients were matched by sex and age with 27,087 control individuals from the general population; the median age for both groups was 67 years, and 72% were men.
  • Participants were categorised into eight age brackets ranging from 40-49 years to 80 years or older. Excess mortality was calculated as the difference between the proportion of patients and that of control individuals who died within 5 years.
  • Researchers assessed all-cause mortality across the age groups over 5 years, with follow-up starting 30 days after coronary angiography to exclude procedure-related deaths.

TAKEAWAY:

  • Overall, 24.6% of patients vs 11.2% of control individuals died within 5 years, with an excess mortality of 13.4% (hazard ratio [HR], 2.43; 95% CI, 2.26-2.61).
  • Excess mortality increased from 6.8% in the 40-49 age group to a peak of 17.0% in the 65-69 age group and decreased to 13.2% in those aged 80 years or older. However, the 40-49 age group had the highest relative risk compared with control peers (HR, 6.41; 95% CI, 3.73-11.05).
  • Patients reached a 5-year mortality threshold of 10% at the age of 50 years, whereas control individuals reached the same only at the age of 70 years — a 20-year difference.
  • Patients with coronary artery disease had higher 5‑year mortality than those without the condition (30.5% vs 18.5%) and greater excess mortality. Overall excess mortality was similar for men and women, although men had slightly higher 5‑year mortality in older age groups.

The study finding supports a proactive clinical approach in younger patients with HFrEF, including early optimisation of guideline-recommended medical treatment, timely evaluation for device-based interventions such as ICD implantable cardioverter defibrillator implantation, and sustained long-term follow-up.

 

https://www.medscape.com/viewarticle/younger-age-offers-no-protection-hfref-deaths-2026a1000a9x

 

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