Yunpeng Zhang1, Ming Yuan1, Mengqi Gong1, Gary Tse2, Guangping Li1, Tong Liu3. 1. Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, PR China. 2. Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, SAR, PR China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, SAR, PR China. 3. Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, PR China. Electronic address: liutongdoc@126.com.
Abstract
OBJECTIVE: Frailty is a known risk factor for adverse outcomes after cardiac interventions. However, the extent to which it increases the likelihood of adverse outcomes in heart failure (HF) patients remains unexplored. Therefore, we conducted this systematic review and meta-analysis to quantify the impact of frailty on prognosis in this patient population. DESIGN: Meta-analysis. SETTING AND PARTICIPANTS: PubMed and Embase were searched for studies that investigated the relationship between frailty and outcomes in patients with HF. The search period was from the beginning of the databases through to December 3, 2017. MEASURES: A total of 342 and 919 entries were retrieved from PubMed and Embase, respectively. Of these, 20 met our inclusion criteria and were therefore included. RESULTS: Frailty significantly increased the risk of all-cause mortality [hazard ratio (HR) = 1.59, 95% confidence interval (CI) = 1.39-1.82, P < .0001, I2 = 55%] and hospitalizations (HR = 1.31, 95% CI = 1.21-1.42, P < .0001, I2 = 0%). Moreover, it was predictive of all-cause mortality after ventricular assist device implantation for advanced HF (HR = 1.62, 95% CI = 1.35-1.94, P < .0001, I2 = 2%). CONCLUSIONS/IMPLICATIONS: Frailty is a significant predictor of all-cause mortality and hospital readmissions in HF. Assessment and close monitoring of frailty status of heart failure patients can potentially better guide clinical management of this population.
OBJECTIVE: Frailty is a known risk factor for adverse outcomes after cardiac interventions. However, the extent to which it increases the likelihood of adverse outcomes in heart failure (HF) patients remains unexplored. Therefore, we conducted this systematic review and meta-analysis to quantify the impact of frailty on prognosis in this patient population. DESIGN: Meta-analysis. SETTING AND PARTICIPANTS: PubMed and Embase were searched for studies that investigated the relationship between frailty and outcomes in patients with HF. The search period was from the beginning of the databases through to December 3, 2017. MEASURES: A total of 342 and 919 entries were retrieved from PubMed and Embase, respectively. Of these, 20 met our inclusion criteria and were therefore included. RESULTS: Frailty significantly increased the risk of all-cause mortality [hazard ratio (HR) = 1.59, 95% confidence interval (CI) = 1.39-1.82, P < .0001, I2 = 55%] and hospitalizations (HR = 1.31, 95% CI = 1.21-1.42, P < .0001, I2 = 0%). Moreover, it was predictive of all-cause mortality after ventricular assist device implantation for advanced HF (HR = 1.62, 95% CI = 1.35-1.94, P < .0001, I2 = 2%). CONCLUSIONS/IMPLICATIONS: Frailty is a significant predictor of all-cause mortality and hospital readmissions in HF. Assessment and close monitoring of frailty status of heart failurepatients can potentially better guide clinical management of this population.
Authors: Yau-Lam Alex Chau; Ji Won Yoo; Ho Chuen Yuen; Khalid Bin Waleed; Dong Chang; Tong Liu; Fang Zhou Liu; Gary Tse; Sharen Lee; Ka Hou Christien Li Journal: J Geriatr Cardiol Date: 2021-05-28 Impact factor: 3.327
Authors: Izabella Uchmanowicz; Christopher S Lee; Cristiana Vitale; Stanisław Manulik; Quin E Denfeld; Bartosz Uchmanowicz; Joanna Rosińczuk; Marcin Drozd; Joanna Jaroch; Ewa A Jankowska Journal: ESC Heart Fail Date: 2020-09-21