Key result
Frailty in post-PCI AMI patients linked to ~129% higher all-cause mortality.
Why the study?
To investigate the prevalence of frailty and its relationship with adverse outcomes in patients with acute myocardial infarction after PCI.
Does frailty increase the risk of adverse outcomes in elderly patients with acute myocardial infarction after percutaneous coronary intervention?
Meta-Analysis (n=274,976)
Does frailty increase the risk of adverse outcomes in elderly patients with acute myocardial infarction after percutaneous coronary intervention?
Frailty is highly prevalent (39%) in patients with AMI undergoing PCI and is associated with a roughly twofold increased risk of mortality, major bleeding, and re-hospitalization.
Answers are grounded in this paper and cite their sources.
Frailty signals higher post-PCI mortality risk in AMI; extends observational data but leaves open whether targeted interventions improve outcomes.
Objective To investigate the prevalence of frailty in patients with acute myocardial infarction after percutaneous coronary intervention and the relationship between frailty and adverse outcomes in patients with acute myocardial infarction after percutaneous coronary intervention. Methods We searched relevant studies published from database establishment to October 2021 and performed a meta-analysis using stata12.0 software. A random-effects model was used for I 2 greater than > 50%; otherwise, a fixed-effects model was used. Results There were 274,976 elderly patients. The degree of frailty was assessed using different frailty assessment tools, the most common of which was the Frailty Index Scale. Nine studies investigated the prevalence of frailty in patients with acute myocardial infarction after PCI, with an overall prevalence of 39% (95% CI: 18%-60%, P < 0.001). Six studies included adverse outcomes in frail patients with acute myocardial infarction after PCI, including all-cause mortality (HR = 2.29, 95%CI:1.65–3.16, P = 0.285), re-hospitalization (HR = 2.53, 95% CI: 1.38–4.63), and in-hospital major bleeding (HR = 1.93, 95% CI: 1.29–2.90,P = 0.825). Conclusion In patients with acute myocardial infarction after PCI, the frailty prevalence is increased, especially in STEMI. Frailty patients after PCI, acute myocardial infarction is more likely to be associated with worse clinical outcomes, such as death, bleeding, and re-hospitalization.
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Yu et al. (2022) conducted a meta-analysis in Acute myocardial infarction after percutaneous coronary intervention (n=274,976). Frailty vs. Non-frailty was evaluated on All-cause mortality (HR 2.29, 95% CI 1.65-3.16, p=0.285). Frailty in patients with acute myocardial infarction after percutaneous coronary intervention was associated with a increased risk of all-cause mortality compared to non-frail patients.
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