Lourdes Vicent1, Albert Ariza-Solé2, Oriol Alegre3, Juan Sanchís4, Ramón López-Palop5, Francesc Formiga2, Violeta González-Salvado5, Héctor Bueno6, María T Vidán1, Pablo Díez-Villanueva7, Emad Abu-Assi8, Manuel Martínez-Sellés1,9. 1. 1 Cardiology Department, Servicio de Cardiología, Hospital Universitario Gregorio Marañón, Spain. 2. 2 Servei de Cardiologia, Hospital Universitari de Bellvitge, Spain. 3. 3 Cardiology Department, Hospital Universitari Germans Trias i Pujol, Spain. 4. 4 Cardiology Department, Hospital San Juan, Spain. 5. 5 Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Spain. 6. 6 Cardiology Department, Hospital Doce de Octubre, Spain. 7. 7 Cardiology Department, Hospital de la Princesa, Spain. 8. 8 Cardiology Department, Hospital Alvaro Cunqueiro, Spain. 9. 9 Cardiology Department, Universidad Complutense, Universidad Europea, Spain.
Abstract
BACKGROUND: A worse prognosis has been reported among women with acute coronary syndrome compared to men. Our aim was to address the role of frailty and sex in the management and prognosis of elderly patients with non-ST-segment elevation acute coronary syndrome. METHODS: A prospective registry in 44 Spanish hospitals including patients aged 80 years and older with non-ST-segment elevation acute coronary syndrome. Frailty assessment was performed using the FRAIL scale. RESULTS: Of a total of 535 patients, 207 (38.7%) were women. Mean age was 84.8±4.0 years, similar in men and women. A prior history of coronary artery disease was more common in men (146, 44.9%) than in women (46, 22.2%), P<0.001. Frailty was less frequent in men (65, 20.2%) than in women (77, 37.8%), P<0.001. Female sex was an independent predictor of death/hospitalisation (hazard ratio (HR) 1.7, 95% confidence interval (CI) 1.1-2.4) and of hospitalisation at 6 months (HR 1.6, 95% CI 1.04-2.4). In men, compared to non-frail patients, both a prefrail status (HR 3.47, 95% CI 1.22-9.89) and frailty (HR 3.19, 95% CI 1.08-9.43) were independently associated with higher mortality. In women only frailty was independently associated with higher mortality (HR 5.68, 95% CI 1.91-16.18, compared to prefrailty or robustness). Frailty was associated with readmissions in men (HR 3.34, 95% CI 1.79-6.22) but not in women. CONCLUSIONS: In octogenarians with acute coronary syndrome female sex was independently associated with death/hospitalisation at 6 months. Frailty was more common in women and was a predictor of poor prognosis. In men prefrailty also predicted a poor prognosis.
BACKGROUND: A worse prognosis has been reported among women with acute coronary syndrome compared to men. Our aim was to address the role of frailty and sex in the management and prognosis of elderly patients with non-ST-segment elevation acute coronary syndrome. METHODS: A prospective registry in 44 Spanish hospitals including patients aged 80 years and older with non-ST-segment elevation acute coronary syndrome. Frailty assessment was performed using the FRAIL scale. RESULTS: Of a total of 535 patients, 207 (38.7%) were women. Mean age was 84.8±4.0 years, similar in men and women. A prior history of coronary artery disease was more common in men (146, 44.9%) than in women (46, 22.2%), P<0.001. Frailty was less frequent in men (65, 20.2%) than in women (77, 37.8%), P<0.001. Female sex was an independent predictor of death/hospitalisation (hazard ratio (HR) 1.7, 95% confidence interval (CI) 1.1-2.4) and of hospitalisation at 6 months (HR 1.6, 95% CI 1.04-2.4). In men, compared to non-frail patients, both a prefrail status (HR 3.47, 95% CI 1.22-9.89) and frailty (HR 3.19, 95% CI 1.08-9.43) were independently associated with higher mortality. In women only frailty was independently associated with higher mortality (HR 5.68, 95% CI 1.91-16.18, compared to prefrailty or robustness). Frailty was associated with readmissions in men (HR 3.34, 95% CI 1.79-6.22) but not in women. CONCLUSIONS: In octogenarians with acute coronary syndrome female sex was independently associated with death/hospitalisation at 6 months. Frailty was more common in women and was a predictor of poor prognosis. In men prefrailty also predicted a poor prognosis.
Authors: Julia Stehli; Diem Dinh; Misha Dagan; Ron Dick; Stephanie Oxley; Angela Brennan; Jeffrey Lefkovits; Stephen J Duffy; Sarah Zaman Journal: Clin Cardiol Date: 2022-03-07 Impact factor: 3.287
Authors: Hanna Ratcovich; Mohammad Alkhalil; Benjamin Beska; Lene Holmvang; Mike Lawless; I Gede Dennis Sukadana; Chris Wilkinson; Vijay Kunadian Journal: Int J Cardiol Heart Vasc Date: 2022-09-06
Authors: Elisabetta Tonet; Albert Ariza-Solé; Matteo Serenelli; Francesc Formiga; Juan Sanchis; Rita Pavasini; Pablo Diez-Villanueva; Francesco Vitali; Clara Bonanad; Giovanni Grazzi; Antoni Carol; Giorgio Chiaranda; Graziella Pompei; Laura Sofia Cardelli; Serena Caglioni; Federico Gibiino; Stefano Volpato; Gianluca Campo Journal: BMC Med Date: 2022-01-20 Impact factor: 8.775