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An Easy Assessment of Frailty at Baseline Independently Predicts Prognosis in Very Elderly Patients With Acute Coronary Syndromes

2017; Elsevier BV; Volume: 19; Issue: 4 Linguagem: Inglês

10.1016/j.jamda.2017.10.007

1538-9375

Oriol Alegre, Françesc Formiga, Ramon López‐Palop, Francisco Marı́n, María Teresa Vidán, Manuel Martínez‐Sellés, Antoni Carol, Alessandro Sionís, Pablo Díez‐Villanueva, Jaime Aboal, Anna Palau-Vendrel, Héctor Bueno, Angel Perez Rivera, Juan Sanchís, Emad Abu‐Assi, Miguel Corbí Santamaría, Juan C. Castillo, Jordi Bañeras, Violeta González‐Salvado, Ángel Cequier, Albert Ariza‐Solé, Oriol Alegre, Albert Ariza‐Solé, Jordi Bañeras, Agnès Rafecas, Cinta Llibre, Miquel Buxons Vives, Alessandro Sionís, Jaime Aboal, Pau Vilardell, Alfredo Bardajı́, Carlos Tomás, Oscar Macho, Manuel Peraire, Ana Lacal, Anna Palau, Vanessa Martínez‐García, Núria Coma, Antoni Carol, Marta Campreciós, Susana Herranz, Sergi Yun, Maria Orriols, Josep Ma Viguer, Juan C. Castillo, Víctor Becerra, Pilar Cardila, Miguel Corbí Santamaría, Javier López, Héctor García‐Pardo, Jose-Ángel Pérez-Rivera, Ana Merino Merino, Francisco Martín‐Herrero, Maria Isabel Garcimartín, Juan Sanchís, Clara Bonanad, Óscar Fabregat, Vícto Pérez-Roselló, Ramon López‐Palop, Miguel Rodríguez-Santamarta, Violeta González‐Salvado, Bernardo García de la Villa, Lluís Asmarats, Jaume Maristany, J. Girós Torres, Marta Gómez-Llorente, Martín J. García‐González, Raquel Pimienta, Ana Viana‐Tejedor, Iván J. Núñez‐Gil, Juan Ruiz-García, Alejandro Cortés Beringola, Héctor Bueno, Manuel Martínez‐Sellés, María Teresa Vidán, Pablo Díez‐Villanueva, Francisco Marı́n, Aitziber Munárriz, N Salterain,

Health Systems, Economic Evaluations, Quality of Life

Background Information about the impact of frailty in patients with acute coronary syndromes (ACS) is scarce. No study has assessed the prognostic impact of frailty as measured by the FRAIL scale in very elderly patients with ACS. Methods The prospective multicenter LONGEVO-SCA registry included unselected patients with ACS aged 80 years or older. A comprehensive geriatric assessment was performed during hospitalization, including frailty assessment by the FRAIL scale. The primary endpoint was mortality at 6 months. Results A total of 532 patients were included. Mean age was 84.3 years, 61.7% male. Most patients had positive troponin levels (84%) and high GRACE risk score values (mean 165). A total of 205 patients were classified as prefrail (38.5%) and 145 as frail (27.3%). Frail and prefrail patients had a higher prevalence of comorbidities, lower left ventricle ejection fraction, and higher mean GRACE score value. A total of 63 patients (11.8%) were dead at 6 months. Both prefrailty and frailty were associated with higher 6-month mortality rates (P < .001). After adjusting for potential confounders, this association remained significant (hazard ratio [HR] 2.71; 95% confidence interval [CI] 1.09–6.73 for prefrailty and HR 2.99; 95% CI 1.20–7.44 for frailty, P = .024). The other independent predictors of mortality were age, Charlson Index, and GRACE risk score. Conclusions The FRAIL scale is a simple tool that independently predicts mortality in unselected very elderly patients with ACS. The presence of prefrailty criteria also should be taken into account when performing risk stratification of these patients.