Key result
Frailty was independently associated with increased mortality following acute coronary syndrome, with adjusted hazard ratios ranging from 1.54 to 5.39.
Why the study?
Does frailty affect the receipt of guideline-indicated care and mortality in older patients presenting with acute coronary syndrome?
Systematic Review (n=10)
Does frailty affect the receipt of guideline-indicated care and mortality in older patients presenting with acute coronary syndrome?
Effect estimate: HR 1.54 to 5.39
Frailty is a significant predictor of increased mortality and underutilization of guideline-directed therapies, including PCI, in older patients with ACS.
May warrant frailty assessment in ACS risk stratification; leaves open optimal management strategies given sparse data.
The health burden of acute coronary syndrome (ACS) and frailty is high, but the impact of frailty on ACS treatment and outcomes is uncertain. In this structured literature review, we investigated the relationship between frailty, ACS treatment and outcomes. Between 2000 and 2016, we identified only a small number of primary research studies investigating frailty and ACS care ( n = 10). Frailty was independently associated with increased mortality following ACS (adjusted all-cause mortality hazard ratios for patients with frailty ranged from 1.54 to 5.39). Older people with frailty were significantly less likely to receive guideline-indicated ACS care, including percutaneous coronary intervention (PCI) (rates ranged from 6.7% to 43.7% vs. from 30.4% to 69.5%). Available data for PCI indicated a gap between treatment recommended by international guidelines and clinical practice. Further research is warranted in order to investigate methods for identifying frailty in the acute setting and opportunities for improving care among older people with frailty presenting with ACS.
No takes yet. Share an insight, caveat, or question.
Bebb et al. (2017) conducted a systematic review in Acute coronary syndrome (n=10). Frailty vs. No frailty was evaluated on All-cause mortality following ACS (HR 1.54 to 5.39). Frailty was independently associated with increased mortality following acute coronary syndrome, with adjusted hazard ratios ranging from 1.54 to 5.39.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: