Dichotomous relationship between age and 30-day death or rehospitalization in Heart Failure Patients Admitted with Acute Decompensated Heart Failure: Results From the ASCEND-HF Trial

Background: Younger age as an independent predictor of death or all-cause rehospitalization at 30 days post-randomization for hospitalized heart failure (HF) patients has not been well described. Methods and Results: ASCEND-HF enrolled 7141 hospitalized acute HF patients (categorized by age: < 45, 45 to < 55, 55 to < 65, 65 to < 75, and ≥75 years) and followed them for 30 days to assess clinical outcomes, which included death or rehospitalization. Patients 45 to < 55 years had the lowest percentages of death (1.4%) and total rehospitalizations (10.7%); percentages increased for younger (3.0% and 12.2%, respectively, for age < 45 y) and older (5.8% and 12.5%, respectively, for age ≥75 y) patients. For those rehospitalized, the total HF-induced readmissions were highest in the youngest (68%) and declined with increasing age (P = .03). Although patients ≥55 years of age were more likely to die or be rehospitalized within 30 days of randomization for each additional 10 years of life, those < 55 years of age had a significant reduction in death or HF rehospitalization for each 10-year increase in age (similar findings for death and HF rehospitalization). Conclusions: There is a dichotomous relationship between age and risk of death or rehospitalization, and death or HF rehospitalization—risk decreases as age increases up to age 55 years, then increases after age 55 years.