Effect of Frailty on the Long-Term Prognosis of Elderly Patients with Acute Myocardial Infarction.

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Clinical Interventions in Aging Pub Date : 2023-12-01 eCollection Date: 2023-01-01 DOI:10.2147/CIA.S433221

Min Zong, Xiaonan Guan, Wen Huang, Jing Chang, Jianjun Zhang

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引用次数: 0

Abstract

Background: To investigate the effect of frailty on the long-term prognosis of elderly patients with acute myocardial infarction (AMI).

Methods: The data of 238 AMI patients (aged ≥75 years) were retrospectively reviewed. They were divided into two groups according to the Modified Frailty Index (mFI): frailty group (mFI≥0.27, n=143) and non-frailty group (mFI<0.27, n=95). The major adverse cardiovascular and cerebrovascular events (MACEs) and Kaplan-Meier survival curves of the two groups were compared. Multivariate Cox regression analysis was used to identify the risk factors for MACEs.

Results: The frailty group showed a significantly older age as well as a higher N-terminal proB-type natriuretic peptide level, Global Registry of Acute Coronary Events score, and CRUSADE bleeding score compared with the non-frailty group (P<0.05). A significantly greater proportion of patients with combined heart failure, atrial fibrillation, comorbidity, and activities of daily living score of <60 was also observed in the frailty group compared with the non-frailty group (P<0.05). At 36 months after AMI, the frailty group vs the non-frailty group showed a significantly poorer survival (log-rank P=0.005), higher incidence of MACEs (50.35 vs 29.47, P=0.001), higher overall mortality rate (20.98% vs 7.37%, P=0.006), higher 30-day mortality rate (13.99% vs 5.26%, P=0.033), higher major bleeding rate (14.69% vs 5.26, P=0.018), and lower repeat revascularization rate (2.10% vs 8.42%, P=0.03). Frailty, type 2 diabetes, and N-terminal proB-type natriuretic peptide ≥1800 pg/mL were independent risk factors for MACEs.

Conclusion: Frailty is an independent risk factor affecting the long-term prognosis of elderly patients with AMI.

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虚弱对老年急性心肌梗死患者长期预后的影响。

背景:探讨衰弱对老年急性心肌梗死(AMI)患者长期预后的影响。方法:回顾性分析238例AMI患者(年龄≥75岁)的资料。根据改良虚弱指数(mFI)分为虚弱组(mFI≥0.27,n=143)和非虚弱组(mFI)。与非衰弱组相比，衰弱组的年龄明显变大，n端b型利钠肽水平、全球急性冠状动脉事件登记评分和CRUSADE出血评分较高(PPP=0.005)， mace发生率较高(50.35 vs 29.47, P=0.001)，总死亡率较高(20.98% vs 7.37%， P=0.006)， 30天死亡率较高(13.99% vs 5.26%， P=0.033)，大出血率较高(14.69% vs 5.26, P=0.018)。重复血运重建率较低(2.10% vs 8.42%， P=0.03)。虚弱、2型糖尿病和n端b型利钠肽≥1800 pg/mL是mace的独立危险因素。结论:虚弱是影响老年AMI患者长期预后的独立危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.80

自引率

2.80%

发文量

193

审稿时长

6-12 weeks

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.