Key result
Frailty was associated with a significantly higher incidence of MACEs (50.35% vs 29.47%, P=0.001) and overall mortality at 36 months in elderly patients with acute myocardial infarction.
Why the study?
To investigate the effect of frailty on the long-term prognosis of elderly patients with acute myocardial infarction.
Does frailty increase the risk of MACEs and mortality in elderly patients (aged ≥ 75 years) with acute myocardial infarction?
Cohort (n=238)
Does frailty increase the risk of MACEs and mortality in elderly patients (aged ≥ 75 years) with acute myocardial infarction?
Absolute Event Rate: 50.35% vs 29.47%
p-value: p=0.001
Frailty is an independent risk factor for worse long-term prognosis, including higher MACE and mortality rates, in elderly patients with acute myocardial infarction.
Frailty (mFI≥0.27) identifies higher MACE risk in elderly AMI; supports prognostic use but leaves open whether interventions improve outcomes.
Background: To investigate the effect of frailty on the long-term prognosis of elderly patients with acute myocardial infarction (AMI). Methods: The data of 238 AMI patients (aged ≥ 75 years) were retrospectively reviewed. They were divided into two groups according to the Modified Frailty Index (mFI): frailty group (mFI≥ 0.27, n=143) and non-frailty group (mFI< 0.27, n=95). The major adverse cardiovascular and cerebrovascular events (MACEs) and Kaplan–Meier survival curves of the two groups were compared. Multivariate Cox regression analysis was used to identify the risk factors for MACEs. Results: The frailty group showed a significantly older age as well as a higher N-terminal proB-type natriuretic peptide level, Global Registry of Acute Coronary Events score, and CRUSADE bleeding score compared with the non-frailty group ( P < 0.05). A significantly greater proportion of patients with combined heart failure, atrial fibrillation, comorbidity, and activities of daily living score of < 60 was also observed in the frailty group compared with the non-frailty group ( P < 0.05). At 36 months after AMI, the frailty group vs the non-frailty group showed a significantly poorer survival (log-rank P =0.005), higher incidence of MACEs (50.35 vs 29.47, P =0.001), higher overall mortality rate (20.98% vs 7.37%, P =0.006), higher 30-day mortality rate (13.99% vs 5.26%, P =0.033), higher major bleeding rate (14.69% vs 5.26, P =0.018), and lower repeat revascularization rate (2.10% vs 8.42%, P =0.03). Frailty, type 2 diabetes, and N-terminal proB-type natriuretic peptide ≥ 1800 pg/mL were independent risk factors for MACEs. Conclusion: Frailty is an independent risk factor affecting the long-term prognosis of elderly patients with AMI.
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Zong et al. (2023) conducted a cohort in acute myocardial infarction (n=238). Frailty (Modified Frailty Index ≥ 0.27) vs. Non-frailty (Modified Frailty Index < 0.27) was evaluated on Major adverse cardiovascular and cerebrovascular events (MACEs) (p=0.001). Frailty was associated with a significantly higher incidence of MACEs (50.35% vs 29.47%, P=0.001) and overall mortality at 36 months in elderly patients with acute myocardial infarction.
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