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
{"title":"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。","authors":"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","doi":"10.26599/1671-5411.2025.01.003","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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; <i>P</i> = 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; <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>In older patients with NSTEACS, frailty independently associates higher all-cause mortality or all-cause hospital admissions at one-year follow-up.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 1","pages":"159-168"},"PeriodicalIF":1.8000,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937830/pdf/","citationCount":"0","resultStr":"{\"title\":\"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.\",\"authors\":\"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\",\"doi\":\"10.26599/1671-5411.2025.01.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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; <i>P</i> = 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; <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>In older patients with NSTEACS, frailty independently associates higher all-cause mortality or all-cause hospital admissions at one-year follow-up.</p>\",\"PeriodicalId\":51294,\"journal\":{\"name\":\"Journal of Geriatric Cardiology\",\"volume\":\"22 1\",\"pages\":\"159-168\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-01-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937830/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Geriatric Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.26599/1671-5411.2025.01.003\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Geriatric Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.26599/1671-5411.2025.01.003","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
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.
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.
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.
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