Background

Heart failure (HF) is a major cause of morbidity and mortality among elderly populations worldwide. Disease progression often results in recurrent hospitalizations, diminished quality of life, and increased healthcare costs. Identifying predictors of heart failure progression is essential for improving patient outcomes and developing targeted interventions.

Objective

To evaluate clinical, biochemical, and demographic predictors associated with heart failure progression among elderly patients.

Methods

A retrospective cohort study was conducted among 850 elderly patients (≥65 years) diagnosed with chronic heart failure across four tertiary care hospitals between January 2022 and December 2024. Data on demographics, comorbidities, laboratory parameters, echocardiographic findings, medication adherence, and hospitalization history were collected. Multivariate logistic regression analysis was performed to identify independent predictors of heart failure progression.

Results

During a median follow-up of 24 months, 312 patients (36.7%) demonstrated significant heart failure progression. Independent predictors included reduced left ventricular ejection fraction (OR=3.4, p<0.001), chronic kidney disease (OR=2.8, p<0.001), elevated NT-proBNP levels (OR=3.1, p<0.001), diabetes mellitus (OR=2.1, p=0.004), anemia (OR=1.9, p=0.012), poor medication adherence (OR=2.6, p<0.001), and previous hospitalization (OR=3.5, p<0.001).

Conclusion

Multiple cardiovascular and systemic factors contribute to heart failure progression in elderly patients. Early identification and aggressive management of modifiable risk factors may reduce disease progression and improve survival outcomes.