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 regist...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.展开更多
文摘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.
