Longitudinal Changes in Frailty and Major Adverse Cardiovascular Events in Patients With Coronary Heart Disease

Figures

• 

  Figure 1. Flowchart of participant inclusion for baseline and transition analyses. ARIC indicates Atherosclerosis Risk in Communities; and CHD, coronary heart disease.

• 

  Figure 2. Discriminative performance of baseline frailty status for MACEs among patients with CHD. A, Receiver operating characteristic curves showing the discriminative performance, quantified by the AUC. B, DCA evaluating clinical utility across a range of risk thresholds; the y axis represents net benefit, and the x axis represents threshold probability. C, NRI and IDI index after adding baseline frailty status to the base model. The base model included age, sex, race, education level, household income, smoking status, drinking status, body mass index, high‐sensitivity troponin T, NT‐proBNP, comorbidity score, use of antihypertensive drugs, use of antidiabetic drugs, and use of lipid‐lowering drugs. AUC indicates area under the curve; CHD, coronary heart disease; DCA, decision curve analysis; IDI, integrated discrimination improvement; MACE, major adverse cardiovascular event; NRI, net reclassification improvement; NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide; and ROC, receiver operating characteristic.

• 

  Figure 3. Associations between longitudinal changes in frailty and the risk of MACEs among patients with CHD. A, Association between changes in frailty status and the risk of MACEs. B, Association between cumulative frailty score and the risk of MACEs. C, Association between changes in frailty scores and the risk of MACEs. HRs and 95% CIs were estimated using Cox proportional hazards models adjusted for age, sex, race, education level, household income, smoking status, drinking status, body mass index, high‐sensitivity troponin T, NT‐proBNP, comorbidity score, use of antihypertensive drugs, use of antidiabetic drugs, and use of lipid‐lowering drugs. We additionally adjusted the models for baseline frailty score in analyses of changes in frailty scores. CHD indicates coronary heart disease; HR, hazard ratio; MACE, major adverse cardiovascular event; and NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide.