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P162: Prevalence and risk factors for QTc interval prolongation in the geriatric outpatient clinic
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Poster presentations, Thursday 18 September 2014 / European Geriatric Medicine 5S1 (2014) S83–S158
3. Older age does not behave as a risk factor of higher comorbidity or higher death rate than in the younger elder population. Table 1
COPD Arrhytmias NYHA III/IV Ejection fraction preserved Death rate
<90 y.o.
≥90 y.o.
p value
22.3% 54.10% 33% 83.50% 17.10%
13.8% 46.10% 24.6% 86.40% 17.00%
0.03 0.05 0.05 n.s. n.s.
This work was supported by the Instituto de Salud Carlos III through PI Project PI09/91116 cofunded by the European Development Fund. P161 Acute heart failure in the elderly T.I. Wu, A.C. Perez ´ Rodr´ıguez, J. Marttini Abarca, F.J. Martin Sanchez, P. Gil Gregorio Hospital Clinico San Carlos, Spain Objectives: Obtaining a better understanding of the clinical and therapeutical characteristics of the elderly population who were hospitalized due to Heart Failure. Methodology: This is a transversal study about patients with heart failure. Data collection was done utilizing the discharge summary of patients with the diagnostic of Acute Heart Failure (according to Framingham clinical criteria) from January 2012 till December 2013. This study included 315 patients, discharged from the Hospitalization Unit of the Geriatrics Department. The following variables were collected: Age, gender, cardiovascular risk factors, comorbidity, prescribed medication, triggering causes and left ventricular function measured through transthroracic echocardiogram. The statistical software used was the SPSS version 15.0. Results: The mean age was 89.69±5.2. The main risk factors were: Hypertension (87%), Diabetes (27.6%), Dyslipidemia (36.8%) and Chronic Kidney Disease (32.1%). The primary geriatric syndromes were: urinary incontinence (60%), cognitive decline (41.5%), immobility (30%) and constipation (30%). The ejection fraction was preserved in 84.9% of patients, valvulopathies in 36.8% and 44.4% had atrial fibrillation. Before admission 62.9% were taking diuretics, 29.8% ACEI, 24.8% beta-blockers and 21.3% were anticoagulated. The main trigger causes were infectious diseases (65.7%) and arrhythmias (19.5%). Conclusions: 1. The majority of patients with heart failure had preserved ejection fraction. 2. Cognitive decline and urinary incontinence were the main geriatric syndromes associated. 3. The main triggering cause were infectious diseases. 4. The most prescribed medication are diuretics. This work was supported by the Instituto de Salud Carlos III through PI Project PI09/91116 cofunded by the European Development Fund. P162 Prevalence and risk factors for QTc interval prolongation in the geriatric outpatient clinic W. Overbeek1 , N. Lam2 , B.C. van Munster3 , L. Tulner4 , C.A. de Groot4 1 Slotervaart ziekenhuis, The Netherlands; 2 Vlietland hospital, Schiedam, The Netherlands; 3 Academic Medical Center, Amsterdam, The Netherlands; 4 Slotervaart Hospital, Amsterdam, The Netherlands Introduction: Prolongation of QTc predispose for torsade de points, a potentially lethal ventricular tachycardia. Certain drugs and
patient factors have been identified as risk factors for acquired prolongation of QTc in selected populations. However, little is known about risk factors for geriatric patients. This group may be at more risk for QTc prolongation because of frequently present multimorbidity and multiple drug treatments. Identification of risk factors in this group could be useful in making decisions regarding drug therapy and QTc-monitoring. Methods: We conducted a cross-sectional observational cohort study on patients in the geriatric outpatient clinic. A standard 12lead electrocardiogram (ECG) was recorded and coded according to the Minnesota code criteria. QT interval was corrected for heart rate using the Bazett formula. Excluded were those with bundle branch block and atrial fibrillation. Medical history, current medication and laboratory data were collected. Risk factors independently associated with QTc prolongation were identified by logistic regression. Results: From 489 patients data were collected. After applying exclusion criteria, data from 298 patients (32% men) were analysed. Mean age was 82 year. 53% of the patients had a history of hypertension, 21% of coronary heart disease and 9% of heart failure. QTc prolongation (QTc >430 ms for men and >450 ms for women) was detected in 32% of the patients (range 431–560 ms). Conclusions: QTc prolongation is a frequently encountered problem in geriatric patients. Being aware of the dangers of this disorder may prevent lethal rhythm disturbances in this high risk population. P163 Mood disorders and cardiovascular diseases in older people G.I. Prada1 , I. Verinceanu1 , R.M. Nacu1 , I.G. Fita1 , A.D. Sociu1 , I.G. Savulescu1 , E. Tapelea1 , C.R. Petrescu1 , I. Amolioaei1 , I.D. Alexa2 1 Ana Aslan, National Institute of Gerontology and Geriatrics, Bucharest, Romania; 2 Gr. T. Popa, University of Medicine and Pharmacy, Iasi, Romania Introduction: Mood disorders are often encountered in elderly. Over 1 in 7 patients with coronary artery disease and 1 in 5 with coronary by-pass have major depression. Moreover, depression increases risk of complications in these patients. Objective was to evaluate impact of depression on elderly with cardio-vascular diseases. Methods: We analyzed 329 older patients admitted to our Institute, 26% men, 74% women, mean age for women 70.35 and for men 73.24. 76% of subjects were form urban area, 66% had an income larger than poverty level. We divided the subjects in 5 age-groups: 65–69 years, 70–74 years, 75–79, 80–84 and ≥85 years. Depression was evaluated by neuropsychological assessment. Results: 44% had both depression and cardiovascular disease, 34% had only cardio-vascular disease and 21% only depression. Alcohol consumption was present in 36% of men and 9% of women. 23% of all subjects had a major cardiocerebrovascular event: 34% coronary events, 59% cerebrovascular events, 7% both types of events. Depression was correlated with presence of other cardiovascular risk factors as obesity, hypercholesterolemia, hypertriglyceridemia and decreased HDL-cholesterol. A longer history of cardiovascular disease (>10 years) was associated with higher risk of depression – Relative Risk = 3.7. Severe depression was more frequent in younger age groups, showing that this type of depression my not allow a longer survival. Depression could be considered a risk factor for arterial hypertension in elderly. Conclusions: Depression and cardiovascular diseases are often associated in elderly and might influence each other. Severity of depression could decrease survival in elderly.
Poster presentations, Thursday 18 September 2014 / European Geriatric Medicine 5S1 (2014) S83–S158
3. Older age does not behave as a risk factor of higher comorbidity or higher death rate than in the younger elder population. Table 1
COPD Arrhytmias NYHA III/IV Ejection fraction preserved Death rate
<90 y.o.
≥90 y.o.
p value
22.3% 54.10% 33% 83.50% 17.10%
13.8% 46.10% 24.6% 86.40% 17.00%
0.03 0.05 0.05 n.s. n.s.
This work was supported by the Instituto de Salud Carlos III through PI Project PI09/91116 cofunded by the European Development Fund. P161 Acute heart failure in the elderly T.I. Wu, A.C. Perez ´ Rodr´ıguez, J. Marttini Abarca, F.J. Martin Sanchez, P. Gil Gregorio Hospital Clinico San Carlos, Spain Objectives: Obtaining a better understanding of the clinical and therapeutical characteristics of the elderly population who were hospitalized due to Heart Failure. Methodology: This is a transversal study about patients with heart failure. Data collection was done utilizing the discharge summary of patients with the diagnostic of Acute Heart Failure (according to Framingham clinical criteria) from January 2012 till December 2013. This study included 315 patients, discharged from the Hospitalization Unit of the Geriatrics Department. The following variables were collected: Age, gender, cardiovascular risk factors, comorbidity, prescribed medication, triggering causes and left ventricular function measured through transthroracic echocardiogram. The statistical software used was the SPSS version 15.0. Results: The mean age was 89.69±5.2. The main risk factors were: Hypertension (87%), Diabetes (27.6%), Dyslipidemia (36.8%) and Chronic Kidney Disease (32.1%). The primary geriatric syndromes were: urinary incontinence (60%), cognitive decline (41.5%), immobility (30%) and constipation (30%). The ejection fraction was preserved in 84.9% of patients, valvulopathies in 36.8% and 44.4% had atrial fibrillation. Before admission 62.9% were taking diuretics, 29.8% ACEI, 24.8% beta-blockers and 21.3% were anticoagulated. The main trigger causes were infectious diseases (65.7%) and arrhythmias (19.5%). Conclusions: 1. The majority of patients with heart failure had preserved ejection fraction. 2. Cognitive decline and urinary incontinence were the main geriatric syndromes associated. 3. The main triggering cause were infectious diseases. 4. The most prescribed medication are diuretics. This work was supported by the Instituto de Salud Carlos III through PI Project PI09/91116 cofunded by the European Development Fund. P162 Prevalence and risk factors for QTc interval prolongation in the geriatric outpatient clinic W. Overbeek1 , N. Lam2 , B.C. van Munster3 , L. Tulner4 , C.A. de Groot4 1 Slotervaart ziekenhuis, The Netherlands; 2 Vlietland hospital, Schiedam, The Netherlands; 3 Academic Medical Center, Amsterdam, The Netherlands; 4 Slotervaart Hospital, Amsterdam, The Netherlands Introduction: Prolongation of QTc predispose for torsade de points, a potentially lethal ventricular tachycardia. Certain drugs and
patient factors have been identified as risk factors for acquired prolongation of QTc in selected populations. However, little is known about risk factors for geriatric patients. This group may be at more risk for QTc prolongation because of frequently present multimorbidity and multiple drug treatments. Identification of risk factors in this group could be useful in making decisions regarding drug therapy and QTc-monitoring. Methods: We conducted a cross-sectional observational cohort study on patients in the geriatric outpatient clinic. A standard 12lead electrocardiogram (ECG) was recorded and coded according to the Minnesota code criteria. QT interval was corrected for heart rate using the Bazett formula. Excluded were those with bundle branch block and atrial fibrillation. Medical history, current medication and laboratory data were collected. Risk factors independently associated with QTc prolongation were identified by logistic regression. Results: From 489 patients data were collected. After applying exclusion criteria, data from 298 patients (32% men) were analysed. Mean age was 82 year. 53% of the patients had a history of hypertension, 21% of coronary heart disease and 9% of heart failure. QTc prolongation (QTc >430 ms for men and >450 ms for women) was detected in 32% of the patients (range 431–560 ms). Conclusions: QTc prolongation is a frequently encountered problem in geriatric patients. Being aware of the dangers of this disorder may prevent lethal rhythm disturbances in this high risk population. P163 Mood disorders and cardiovascular diseases in older people G.I. Prada1 , I. Verinceanu1 , R.M. Nacu1 , I.G. Fita1 , A.D. Sociu1 , I.G. Savulescu1 , E. Tapelea1 , C.R. Petrescu1 , I. Amolioaei1 , I.D. Alexa2 1 Ana Aslan, National Institute of Gerontology and Geriatrics, Bucharest, Romania; 2 Gr. T. Popa, University of Medicine and Pharmacy, Iasi, Romania Introduction: Mood disorders are often encountered in elderly. Over 1 in 7 patients with coronary artery disease and 1 in 5 with coronary by-pass have major depression. Moreover, depression increases risk of complications in these patients. Objective was to evaluate impact of depression on elderly with cardio-vascular diseases. Methods: We analyzed 329 older patients admitted to our Institute, 26% men, 74% women, mean age for women 70.35 and for men 73.24. 76% of subjects were form urban area, 66% had an income larger than poverty level. We divided the subjects in 5 age-groups: 65–69 years, 70–74 years, 75–79, 80–84 and ≥85 years. Depression was evaluated by neuropsychological assessment. Results: 44% had both depression and cardiovascular disease, 34% had only cardio-vascular disease and 21% only depression. Alcohol consumption was present in 36% of men and 9% of women. 23% of all subjects had a major cardiocerebrovascular event: 34% coronary events, 59% cerebrovascular events, 7% both types of events. Depression was correlated with presence of other cardiovascular risk factors as obesity, hypercholesterolemia, hypertriglyceridemia and decreased HDL-cholesterol. A longer history of cardiovascular disease (>10 years) was associated with higher risk of depression – Relative Risk = 3.7. Severe depression was more frequent in younger age groups, showing that this type of depression my not allow a longer survival. Depression could be considered a risk factor for arterial hypertension in elderly. Conclusions: Depression and cardiovascular diseases are often associated in elderly and might influence each other. Severity of depression could decrease survival in elderly.