Rita Pavasini1, Elisa Maietti2,3, Elisabetta Tonet1, Giulia Bugani1, Matteo Tebaldi1, Simone Biscaglia1, Paolo Cimaglia1, Matteo Serenelli1, Rossella Ruggiero1, Francesco Vitali1, Marcello Galvani4, Monica Minarelli5, Andrea Rubboli6, Davide Bernucci1, Stefano Volpato3, Gianluca Campo7,8. 1. Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, 44124, Cona, Fe, Italy. 2. Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy. 3. Department of Medical Science, University of Ferrara, Ferrara, Italy. 4. Unità Operativa di Cardiologia, Ospedale GB Morgagni, Forlì, Italy. 5. Department of Emergency, Division of Cardiology, Delta Hospital, Azienda Unità Sanitaria Locale di Ferrara, Ferrara, Italy. 6. Division of Cardiology, S. Maria Delle Croci Hospital, Ravenna, Italy. 7. Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, 44124, Cona, Fe, Italy. cmpglc@unife.it. 8. Maria Cecilia Hospital, GVM Care & Research, Cotignola, RA, Italy. cmpglc@unife.it.
Abstract
PURPOSE: Hitherto, no study has yielded important information on whether the scales of frailty may improve the ability to discriminate the risk of haemorrhages in older adults admitted to hospital for acute coronary syndrome (ACS). The aim of this study is to investigate whether frailty scales would predict the 1-year occurrence of haemorrhagic events and if they confer a significant incremental prognostic value over the bleeding risk scores. METHODS: The present study involved 346 ACS patients aged ≥ 70 years enrolled in the FRASER study. Seven different scales of frailty and PARIS, PRECISE-DAPT and BleeMACS bleeding risk scores were available for each patient. The outcomes were the 1-year BARC 3-5 and 2 bleeding events. RESULTS: Adherence to antiplatelet treatment at 1, 6 and 12 months was 98%, 87% and 78%, respectively. At 1-year, 14 (4%) and 30 (9%) patients presented BARC 3-5 and 2 bleedings, respectively. Bleeding risk scores and four scales of frailty (namely Short Physical Performance Battery, Columbia, Edmonton and Clinical Frailty Scale) significantly discriminated the occurrence of BARC 3-5 events. The addition of the scales of frailty to bleeding risk scores did not lead to a significant improvement in the ability to predict BARC 3-5 bleedings. Neither the bleeding risk scores nor the scales of frailty predicted BARC 2 bleedings. CONCLUSIONS: Both the bleeding risk scores and the scales of frailty predicted BARC 3-5 haemorrhages. However, integrating the scales of frailty with the bleeding risk scores did not improve their discriminative ability. CLINICAL TRIAL REGISTRATION: www.clinicaltrials.gov: NCT02386124.
PURPOSE: Hitherto, no study has yielded important information on whether the scales of frailty may improve the ability to discriminate the risk of haemorrhages in older adults admitted to hospital for acute coronary syndrome (ACS). The aim of this study is to investigate whether frailty scales would predict the 1-year occurrence of haemorrhagic events and if they confer a significant incremental prognostic value over the bleeding risk scores. METHODS: The present study involved 346 ACSpatients aged ≥ 70 years enrolled in the FRASER study. Seven different scales of frailty and PARIS, PRECISE-DAPT and BleeMACS bleeding risk scores were available for each patient. The outcomes were the 1-year BARC 3-5 and 2 bleeding events. RESULTS: Adherence to antiplatelet treatment at 1, 6 and 12 months was 98%, 87% and 78%, respectively. At 1-year, 14 (4%) and 30 (9%) patients presented BARC 3-5 and 2 bleedings, respectively. Bleeding risk scores and four scales of frailty (namely Short Physical Performance Battery, Columbia, Edmonton and Clinical Frailty Scale) significantly discriminated the occurrence of BARC 3-5 events. The addition of the scales of frailty to bleeding risk scores did not lead to a significant improvement in the ability to predict BARC 3-5 bleedings. Neither the bleeding risk scores nor the scales of frailty predicted BARC 2 bleedings. CONCLUSIONS: Both the bleeding risk scores and the scales of frailty predicted BARC 3-5 haemorrhages. However, integrating the scales of frailty with the bleeding risk scores did not improve their discriminative ability. CLINICAL TRIAL REGISTRATION: www.clinicaltrials.gov: NCT02386124.
Authors: Naila Ijaz; Brian Buta; Qian-Li Xue; Denise T Mohess; Archana Bushan; Henry Tran; Wayne Batchelor; Christopher R deFilippi; Jeremy D Walston; Karen Bandeen-Roche; Daniel E Forman; Jon R Resar; Christopher M O'Connor; Gary Gerstenblith; Abdulla A Damluji Journal: J Am Coll Cardiol Date: 2022-02-08 Impact factor: 24.094