Gonzalo Luis Alonso Salinas 1 , Marcelo Sanmartín Fernández 2 , Marina Pascual Izco 2 , Roberto Martín Asenjo 3 , Alejandro Recio-Mayoral 4 , Luis Salvador Ramos 5 , Domingo Marzal Martín 5 , Asunción Camino López 2 , Manuel Jiménez Mena 2 , José Luis Zamorano Gómez 2 Show Affiliations »
Abstract
BACKGROUND: Frailty is a biological condition that reflects a state of decreased physiological reserve and vulnerability to stressors. The role of frailty in acute coronary syndrome patients has not been fully explored. Our study aims to assess the prevalence of frailty and its impact on in-hospital adverse outcomes of patients aged ⩾75 years admitted for acute coronary syndrome. METHODS: This prospective, observational study included patients aged ⩾75 years admitted due to type 1 myocardial infarction in four tertiary hospitals. Frailty was assessed by the SHARE-FI index. The primary endpoint was the combination of in-hospital death or non-fatal myocardial (re)infarction. Secondary endpoints included the assessment of individual rates of (re)infarction, mortality, stroke, major bleeding and the combination of in-hospital death, (re)infarction and mortality. RESULTS: A total of 202 patients were analysed. Frail patients (n=71, 35.1%) were older, more often women, had higher rates of comorbidities, and a higher risk profile according to GRACE, TIMI and CRUSADE scores at admission. The primary endpoint was significantly more frequent among frail patients (9.9% vs. 1.5%; P=0.006), as well as the combination of death, myocardial infarction and stroke (11.3% vs. 1.5%; P=0.002), driven mainly by a higher mortality rate (8.5% vs 0.8%; P=0.004). On multivariate analysis, frailty phenotype was an independent predictor of major adverse cardiac events (odds ratio 7.13; 95% confidence interval 1.43-35.42). CONCLUSIONS: Over one third of elderly patients with high-risk acute coronary syndrome are frail. Frailty phenotype is an important and independent prognostic marker in these patients. © The European Society of Cardiology 2016.
BACKGROUND: Frailty is a biological condition that reflects a state of decreased physiological reserve and vulnerability to stressors. The role of frailty in acute coronary syndrome patients has not been fully explored. Our study aims to assess the prevalence of frailty and its impact on in-hospital adverse outcomes of patients aged ⩾75 years admitted for acute coronary syndrome . METHODS: This prospective, observational study included patients aged ⩾75 years admitted due to type 1 myocardial infarction in four tertiary hospitals. Frailty was assessed by the SHARE-FI index. The primary endpoint was the combination of in-hospital death or non-fatal myocardial (re)infarction . Secondary endpoints included the assessment of individual rates of (re)infarction , mortality, stroke , major bleeding and the combination of in-hospital death, (re)infarction and mortality. RESULTS: A total of 202 patients were analysed. Frail patients (n=71, 35.1%) were older, more often women , had higher rates of comorbidities, and a higher risk profile according to GRACE, TIMI and CRUSADE scores at admission. The primary endpoint was significantly more frequent among frail patients (9.9% vs. 1.5%; P=0.006), as well as the combination of death, myocardial infarction and stroke (11.3% vs. 1.5%; P=0.002), driven mainly by a higher mortality rate (8.5% vs 0.8%; P=0.004). On multivariate analysis, frailty phenotype was an independent predictor of major adverse cardiac events (odds ratio 7.13; 95% confidence interval 1.43-35.42). CONCLUSIONS: Over one third of elderly patients with high-risk acute coronary syndrome are frail. Frailty phenotype is an important and independent prognostic marker in these patients . © The European Society of Cardiology 2016.
Entities: Disease
Species
Keywords:
Acute coronary syndrome; acute myocardial infarction; elderly; frailty
Mesh： See more »
Year: 2016
PMID： 27091834 DOI： 10.1177/2048872616644909
Source DB: PubMed Journal: Eur Heart J Acute Cardiovasc Care ISSN： 2048-8726