Key result
In older patients with NSTEACS, frailty was independently associated with higher 1-year all-cause mortality or rehospitalization (HR 2.23; 95% CI 1.43-3.46; P<0.001).
Why the study?
To evaluate the prevalence and 1-year prognosis associated with frailty in a contemporary cohort of older patients with NSTEACS.
Does frailty increase the risk of all-cause mortality or hospitalizations in older patients with NSTEACS undergoing coronary angiography?
Cohort (n=567)
Does frailty increase the risk of all-cause mortality or hospitalizations in older patients with NSTEACS undergoing coronary angiography?
In older patients with NSTEACS undergoing coronary angiography, frailty is independently associated with a significantly higher risk of 1-year all-cause mortality or hospital admissions.
May improve risk stratification in older NSTEACS patients; supports incorporating frailty into prognostic models.
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
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Díez‐Villanueva et al. (2025) conducted a cohort in non-ST-elevation acute coronary syndrome (NSTEACS) (n=567). Frailty vs. Robust patients was evaluated on composite of all-cause mortality or all-cause hospitalizations (HR 2.23, 95% CI 1.43-3.46, p=< 0.001). In older patients with NSTEACS, frailty was independently associated with higher 1-year all-cause mortality or rehospitalization (HR 2.23; 95% CI 1.43-3.46; P<0.001).
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