Key result
Frailty in older patients with acute coronary syndrome was associated with increased 30-day mortality (adjusted OR 3.28; 95% CI 1.59-6.76) but did not independently impact the receipt of PCI.
Why the study?
There has been limited evidence about frailty in older patients with acute coronary syndrome in Vietnam.
Does frailty increase the risk of adverse outcomes in older patients hospitalized with acute coronary syndrome?
Observational (n=324)
Yes
Does frailty increase the risk of adverse outcomes in older patients hospitalized with acute coronary syndrome?
Odds Ratio: 0.66 (95% CI 0.41–1.08)
Absolute Event Rate: 41.7% vs 58.3%
p-value: p=0.003
Frailty is highly prevalent in older Vietnamese patients with ACS and is independently associated with significantly increased short-term mortality and readmission.
Frailty screening may identify high-risk older ACS patients in Vietnam; leaves open whether it improves PCI selection or outcomes.
BACKGROUND: There has been limited evidence about frailty in older patients with acute coronary syndrome (ACS) in Vietnam. AIM: (1) To investigate the prevalence of frailty in older patients hospitalised with ACS and its associated factors; (2) To investigate the impact of frailty on percutaneous coronary intervention (PCI) and adverse outcomes in this population. METHODS: Patients aged ≥60 with ACS admitted to two teaching hospitals in Vietnam were recruited from 9/2017 to 4/2018. Frailty was defined by the Reported Edmonton Frail Scale. Multivariate logistic regression was applied to investigate the associated factors of frailty and the impact of frailty on PCI and adverse outcomes. RESULTS: There were 324 participants, mean age 73.5±8.3, 39.2% female. The prevalence of frailty was 48.1%. Advanced age, female gender, history of hypertension, heart failure, stroke and chronic kidney disease were significantly associated with a frailty status. Overall, 50.3% of the participants received PCI (58.3% in the non-frail vs 41.7% in the frail, p=0.003). However, frailty did not have an independent impact on PCI (adjusted OR 0.66, 95% CI 0.41-1.08). Frailty was significantly associated with increased risk of having arrhythmia during hospitalisation (adjusted OR 2.24, 95% CI 1.32-3.80), hospital-acquired pneumonia (adjusted OR 2.27, 95% CI 1.24-4.17), in-hospital mortality (adjusted OR 3.02, 95% CI 1.35-6.75), 30-day mortality (adjusted OR 3.28, 95% CI 1.59-6.76), and 30-day readmission (adjusted OR 2.53, 95% CI 1.38-4.63). CONCLUSION: In this study, frailty was present in nearly half of older patients with ACS and was associated with increased adverse outcomes. These findings suggest that frailty screening should be performed in older patients with ACS in Vietnam.
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Nguyen et al. (2019) conducted an observational in Acute coronary syndrome (ACS) (n=324). Frailty vs. Non-frail was evaluated on Receipt of percutaneous coronary intervention (PCI) (adjusted OR 0.66, 95% CI 0.41-1.08, p=0.003). Frailty in older patients with acute coronary syndrome was associated with increased 30-day mortality (adjusted OR 3.28; 95% CI 1.59-6.76) but did not independently impact the receipt of PCI.
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