Impact of Intrinsic Capacity on 5-year Mortality of Older Patients With Cardiovascular Disease.

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Reviews in cardiovascular medicine Pub Date : 2025-08-28 eCollection Date: 2025-08-01 DOI:10.31083/RCM37477

Yuhao Wan, Wenzheng Li, Junpeng Liu, Ke Chai, Hua Wang, Jiefu Yang

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Abstract

Background: Intrinsic capacity (IC) is defined as the combination of all physical and mental (including psychosocial) capacities that an individual can rely on at any given time. Previous studies have shown that a decline in IC is linked to an increased mortality rate. Thus, this study aimed to evaluate the impact of IC on the 5-year mortality of older people with cardiovascular disease.

Methods: This was a prospective cohort study conducted at a tertiary-level A hospital in China between September 2018 and April 2019, with a follow-up period of 5 years. We applied a proposed IC score to assess the baseline IC of each participant. The primary clinical outcome was 5-year all-cause mortality.

Results: A total of 524 older patients (mean age, 75.2 ± 6.5 years; 51.7% men) were enrolled from the cardiology ward. A total of 86 patients (16.5%) experienced all-cause mortality over the 5-year follow-up period. Compared with the survival group, patients in the mortality group were older (81.1 ± 5.7 vs. 74.0 ± 6.0; p < 0.01), showed a higher male proportion (61.6% vs. 49.8%; p = 0.04), had a lower intrinsic score [7.0 (6.0, 8.0) vs. 8.0 (7.0, 9.0); p < 0.01], and a higher prevalence rates of atrial fibrillation or atrial flutter (34.9% vs. 20.1%; p < 0.01), heart failure (44.2% vs.11.2%; p < 0.01), diabetes (48.8% vs. 33.1%; p < 0.01), and chronic kidney disease (19.8% vs. 4.3%; p < 0.01). After adjusting for covariates, multivariate Cox regression showed that the IC score was associated with a lower hazard ratio of 5-year all-cause mortality (hazard ratio (HR) = 0.79, 95% confidence interval (CI): 0.69-0.92, p < 0.01).

Conclusions: Among these older aged patients with cardiovascular disease, the IC score is independently associated with 5-year all-cause mortality, with a lower IC score indicating a poorer prognosis.

Clinical trial registration: ChiCTR1800017204; date of registration: 07/18/2018. URL: https://www.chictr.org.cn/showproj.html?proj=28931.

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内在能力对老年心血管疾病患者5年死亡率的影响

背景：内在能力（IC）被定义为个体在任何特定时间可以依赖的所有生理和心理（包括社会心理）能力的组合。先前的研究表明，IC的下降与死亡率的增加有关。因此，本研究旨在评估IC对老年心血管疾病患者5年死亡率的影响。方法：本研究于2018年9月至2019年4月在中国某三级甲等医院开展前瞻性队列研究，随访5年。我们采用建议的IC评分来评估每个参与者的基线IC。主要临床结果为5年全因死亡率。结果：共有524例老年患者（平均年龄75.2±6.5岁，51.7%为男性）从心内科病房入组。在5年随访期间，共有86例患者（16.5%）出现全因死亡。与生存组比较，死亡组患者年龄较大（81.1±5.7∶74.0±6.0∶p < 0.01），男性比例较高（61.6%∶49.8%∶p = 0.04），内在评分较低[7.0(6.0,8.0)∶8.0 (7.0,9.0)；房颤或心房扑动（34.9%比20.1%,P < 0.01）、心力衰竭（44.2%比11.2%,P < 0.01）、糖尿病（48.8%比33.1%,P < 0.01）和慢性肾脏疾病（19.8%比4.3%,P < 0.01）的患病率较高。校正协变量后，多因素Cox回归显示，IC评分与5年全因死亡率的风险比较低相关(风险比（HR) = 0.79, 95%可信区间（CI）： 0.69 ~ 0.92, p < 0.01）。结论：在这些老年心血管疾病患者中，IC评分与5年全因死亡率独立相关，IC评分越低预后越差。临床试验注册：ChiCTR1800017204；注册日期：2018年7月18日。URL: https://www.chictr.org.cn/showproj.html?proj=28931。

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来源期刊

Reviews in cardiovascular medicine 医学-心血管系统

CiteScore

2.70

自引率

3.70%

发文量

377

审稿时长

1 months

期刊介绍： RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.