One-year clinical events according to frailty in older patients with non-ST elevation acute coronary syndrome undergoing coronary angiography: an analysis of the IMPACT-TIMING-GO study.

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Geriatric Cardiology Pub Date : 2025-01-28 DOI:10.26599/1671-5411.2025.01.003

Pablo Díez-Villanueva, Pedro Cepas-Guillén, María Thiscal López Lluva, Alfonso Jurado-Román, Pablo Bazal-Chacón, Martín Negreira-Caamaño, Iván Olavarri-Miguel, Ane Elorriaga, Ricardo Rivera-López, David Escribano, Pablo Salinas, María Martínez-Avial, Antonio Martínez-Guisado, Clea González-Maniega, Felipe Díez-Delhoyo

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Abstract

Objective: To evaluate the prevalence and one-year prognosis associated with frailty in a contemporary cohort of older patients with non-ST-elevation acute coronary syndrome (NSTEACS).

Methods: The IMPACT-TIMING-GO registry (IMPACT of Time of Intervention in patients with Myocardial Infarction with Non-ST seGment elevation. ManaGement and Outcomes) prospectively included 1020 patients with NSTEACS undergoing invasive coronary angiography between April and May 2021. For this sub-study, patients ≥ 65 years were selected. Frailty was assessed according to FRAIL scale. We studied all-cause mortality and the composite of all-cause mortality or all-cause hospitalizations at one-year follow-up after discharge.

Results: Five hundred and sixty seven patients (mean age: 75.8 ± 6.7 years, 28.2% women) were included: 316 (55.7%) were robust, 183 (32.3%) prefrail, and 68 (12.0%) frail. Frail patients were significantly older, more often women, and presented a worse baseline clinical profile. There were no differences among groups regarding pretreatment with a P2Y12 inhibitor. An urgent angiography (< 24 h) was less frequently performed in frail patients, with no differences regarding revascularization approach or in main in-hospital adverse events, although acute kidney disease occurred more frequently in frail patients. At 1-year follow-up, 20 patients died (3.6%). Chronic kidney disease was independently associated with 1-year all-cause death, although a trend towards higher mortality was observed in frail patients (HR = 3.01; 95% CI: 0.93-9.78; P = 0.065). Frailty was independently associated with higher 1-year all-cause mortality or all-cause rehospitalizations (HR = 2.23; 95% CI: 1.43-3.46; P < 0.001).

Conclusions: In older patients with NSTEACS, frailty independently associates higher all-cause mortality or all-cause hospital admissions at one-year follow-up.

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接受冠状动脉造影术的非ST段抬高急性冠状动脉综合征老年患者一年内发生的临床事件与体弱程度的关系：IMPACT-TIMING-GO 研究分析。

目的：评价当代老年非st段抬高急性冠状动脉综合征（NSTEACS）患者的患病率和与虚弱相关的一年预后。方法：对非st段抬高的心肌梗死患者进行干预时间的影响（IMPACT - timing - go）登记。管理和结果)前瞻性纳入了2021年4月至5月期间接受有创冠状动脉造影的1020例NSTEACS患者。在这个亚研究中，选择年龄≥65岁的患者。根据虚弱量表评估虚弱程度。我们研究了出院后一年随访的全因死亡率和全因死亡率或全因住院的综合情况。结果：共纳入567例患者（平均年龄：75.8±6.7岁，女性28.2%），其中健全型316例（55.7%），体弱型183例（32.3%），体弱型68例（12.0%）。虚弱的患者明显年龄较大，多为女性，并且表现出较差的基线临床概况。在P2Y12抑制剂预处理方面，各组之间没有差异。体弱患者进行紧急血管造影（< 24 h）的频率较低，在血运重建方式或主要住院不良事件方面没有差异，尽管急性肾脏疾病在体弱患者中发生的频率更高。1年随访时，20例患者死亡（3.6%）。慢性肾脏疾病与1年全因死亡独立相关，尽管虚弱患者的死亡率呈上升趋势(HR = 3.01；95% ci: 0.93-9.78；P = 0.065)。虚弱与较高的1年全因死亡率或全因再住院率独立相关(HR = 2.23；95% ci: 1.43-3.46；P < 0.001)。结论：在老年NSTEACS患者中，衰弱与一年随访时较高的全因死亡率或全因住院率独立相关。

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

Journal of Geriatric Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-GERIATRICS & GERONTOLOGY

CiteScore

3.30

自引率

4.00%

发文量

1161

期刊介绍： JGC focuses on both basic research and clinical practice to the diagnosis and treatment of cardiovascular disease in the aged people, especially those with concomitant disease of other major organ-systems, such as the lungs, the kidneys, liver, central nervous system, gastrointestinal tract or endocrinology, etc.