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Title: Frailty is an independent prognostic marker in elderly patients with myocardial infarction.
Authors: Alonso Salinas, Gonzalo Luis
Sanmartin, Marcelo
Pascual Izco, Marina
Rincon, Luis Miguel
Pastor Pueyo, Pablo
Marco Del Castillo, Alvaro
Garcia Guerrero, Alberto
Caravaca Perez, Pedro
Recio-Mayoral, Alejandro
Camino, Asuncion
Jimenez-Mena, Manuel
Zamorano, José Luis
Keywords: Acute Coronary Syndrome;Acute Myocardial Infarction;Aging;Frailty;Prognosis
metadata.dc.subject.mesh: Age Factors
Aged, 80 and over
Chi-Square Distribution
Frail Elderly
Kaplan-Meier Estimate
Logistic Models
Multivariate Analysis
Myocardial Infarction
Odds Ratio
Prospective Studies
Risk Factors
Tertiary Care Centers
Time Factors
Issue Date: 16-Jul-2017
Abstract: Acute coronary syndrome (ACS) patients are increasingly older. Conventional prognostic scales include chronological age but do not consider vulnerability. In elderly patients, a frail phenotype represents a better reflection of biological age. This study aims to determine the prevalence of frailty and its influence on patients age ≥75 years with ACS. Patients age ≥75 years admitted due to type 1 myocardial infarction were included in 2 tertiary hospitals, and clinical data were collected prospectively. Frailty was defined at admission using the previously validated Survey of Health Ageing and Retirement in Europe Frailty Index (SHARE-FI) tool. The primary endpoint was the combination of death or nonfatal myocardial reinfarction during a follow-up of 6 months. Major bleeding (hemoglobin decrease ≥3 g/dL or transfusion needed) and readmission rates were also explored. A total of 234 consecutive patients were included. Frail patients (40.2%) had a higher-risk profile, based on higher age and comorbidities. On multivariate analysis, frailty was an independent predictor of the combination of death or nonfatal myocardial reinfarction (adjusted hazard ratio [aHR]: 2.54, 95% confidence interval [CI]: 1.12-5.79), an independent predictor of the combination of death, nonfatal myocardial reinfarction, or major bleeding (aHR: 2.14, 95% CI: 1.13-4.04), and an independent predictor of readmission (aHR: 1.80, 95% CI: 1.00-3.22). Frailty phenotype at admission is common among elderly patients with ACS and is an independent predictor for severe adverse events. It should be considered in future risk-stratification models.
metadata.dc.identifier.doi: 10.1002/clc.22749
Appears in Collections:Producción 2020

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