{
  "abstract": "Background As preventive cardiology increasingly includes older adults, better understanding of preclinical heart failure (HF) in patients aged ≥80 years is essential.Objective To characterise the clinical trajectory, comorbidity burden, echocardiographic profile, and event incidence among adults aged ≥80 years with Stage A or B HF.Methods From 1,425 participants in the STOP-HF programme (mean follow-up 5.4 years), 80 patients aged ≥80 years (5.6%) were identified. Clinical characteristics, BNP, echocardiographic indices, and cardiovascular events were compared with patients aged <80.Results The ≥80 group (mean age 82.9; 54% female) had higher median BNP (71.1 vs 38.2 pg/mL). Median BMI was lower (26.7 vs 28.7 kg/m 2). The ≥80 group had similar LVEF (66.4 vs 66.1%), and lower LVEDD (44.0 vs 46.6 mm) versus the <80 group. Diastolic dysfunction markers were elevated: LAVI (32.2 vs 26.3 mL/m2), E/e′ (11.1 vs 8.6), LVMI (97.7 vs 95.3 g/m2). Atrial fibrillation was more common (16.3% vs 8.8%); diabetes was slightly lower (33.8% vs 37.9%). Most older adults remained stable or improved: 78% of ≥80s either maintained or regressed in HF stage, with 6.2% showing regression from Stage B to A. Among Stage B patients aged ≥80, 81% remained stable, 6.2% improved, and 12.5% progressed to Stage C. Transitions correlated with BNP values. Despite elevated biomarkers and remodelling, the ≥80 group accounted for only 10.2% of acute HF events, and their contribution to non-HF cardiac (5.6%) and non-cardiac (7.0%) events was proportionate to cohort size.Conclusion Despite elevated BNP and structural changes, most ≥80s with preclinical HF remain stable, and some regress. Their absolute event burden is low. Standard BNP thresholds may overstate risk. These findings support age-adjusted biomarker interpretation to guide risk-based screening and efficient resource allocation.",
  "authors": [
    {
      "affiliations": [
        "St Vincents University Hospital, Dublin, Ireland"
      ],
      "name": "A Moore"
    },
    {
      "affiliations": [
        "St Vincents University Hospital, Dublin, Ireland"
      ],
      "name": "M Barrett"
    },
    {
      "affiliations": [
        "St Vincents University Hospital, Dublin, Ireland"
      ],
      "name": "J Gallagher"
    },
    {
      "affiliations": [
        "St Vincents University Hospital, Dublin, Ireland"
      ],
      "name": "M Ledwidge"
    },
    {
      "affiliations": [
        "St Vincents University Hospital, Dublin, Ireland"
      ],
      "name": "K McDonald"
    }
  ],
  "title": "6 All BNP and no bang? natural history of the 80+ preclinical HF population",
  "uid": "6e2e9ce7-c137-59bc-8281-20c135a6bd01"
}