COMPLEX TREATMENT EFFECT ON SURVIVAL OF ELDERLY PATIENTS WITH CHRONIC HEART FAILURE AND CARDIO-RENAL SYNDROME

Aim of the research — carrying out of a five years’ survival of patients with chronic heart failure (CHF) and cardio-renal syndrome (CRS) as a result of a complex treatment.

Basic criteria of enrolling into investigation are: presence of CHF and CRS, diagnostics of which was based on defining rate of glomerular filtration within the limits of 30–90 ml/min/1.73 m2 and presence of AS АС (Hb<120 g/l), which develops 3–10 years after clinical manifestation of CHF.

There were 309 patients of elderly age (60–73 years old) with II–IV functional class (FC) of CHF of ischemic genesis and CRS of the main group aged (66.8±6.3) years, average duration of the disease — (7.11±3.9) years were examined. Of them 207 patients (159 females and 48 males, average age — (66.5±6.9) years) made up a subgroup of patients with preserved ejection fraction (EF) of the left ventricle (LV) (LV>45%) and 102 patients (79 females and 23 males, aged — (67.2±5.4) years) — subgroup with systolic dysfunction of LV (EF45%). Group of comparison was made up of 73 elderly patients (18 males and 55 females) with ІІ–ІV FC of CHF with preserved EF of LV without CRS aged (65.9±4.6) years. Complex treatment of patients included standard means of long-term drug therapy of CHF, correction of anemia syndrome and endothelial dysfunction.

Analysis of findings of 5-years’ survival was carried out using Kaplan-Meyer’s procedure. Reliability of differences of curves of 5-years’ survival was assessed according to Gehan’s Wilcoxon test (GWT) and Log-Rank Test (LRT) criteria.

It was proved that five-years’ survival of elderly patients with CHF and CRS with preserved left ventricular ejection fraction and systolic dysfunction against a background treatment is comparable with the one in the group of patients with CHF without CRS (52.90±0.03)% and (50.50±0.05)% against (53.20±0.06)%; p>0.30, this being a positive result. However absence of reliable difference between findings gives possibility to state that there is no significant impact of treatment of patients with CHF and CRS on long-term prognosis (5-years’ survival). So, results of our investigation fully coincide with the results of RED-HF ones and randomized placebo-controlled investigation FAIR-HF.