The Assessment of Scales of Frailty and Physical Performance Improves Prediction of Major Adverse Cardiac Events in Older Adults with Acute Coronary Syndrome
Key result
Adding SPPB to baseline characteristics improves 1-year MACCE prediction in older ACS patients.
- ΔC-statistic 0.043
- P=0.04
- n=402
Why the study?
The number of older adults admitted with ACS has increased worldwide, but it was unclear which scale of frailty or physical performance provides incremental improvements in risk stratification.
Does the assessment of physical performance with the SPPB scale improve the prediction of MACCE and all-cause mortality in older adults with acute coronary syndrome?
Population
402 older (≥70 years) ACS patients
Comparison
Seven scales of frailty and physical performance added to baseline characteristics and risk scores
Design
Prospective cohort study
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
SPPB may refine MACCE risk stratification at discharge in older ACS patients; leaves open whether it improves outcomes or warrants routine adoption pending validation.
Study Design
Type
Cohort (n=402)
Structured PICO
Does the assessment of physical performance with the SPPB scale improve the prediction of MACCE and all-cause mortality in older adults with acute coronary syndrome?
P
Population
402 older (≥70 years) patients with acute coronary syndrome followed for 1 year.
E
Exposure
Assessment of frailty and physical performance using the short physical performance battery (SPPB) scale before hospital discharge
C
Comparator
Baseline characteristics and traditional risk scores (GRACE and TIMI) alone
O
Outcome
1-year occurrence of major adverse cardiac and cerebrovascular events (MACCE: cardiac death, reinfarction, and cerebrovascular accident) and all-cause mortalitycomposite
Main Result
Effect estimate: ΔC-statistic 0.043
p-value: p=0.04
Assessing physical performance with the SPPB scale before hospital discharge significantly improves the prediction of 1-year MACCE and all-cause mortality in older patients with ACS beyond traditional risk scores.
Cite This Study
Campo et al. (2019) conducted a cohort in Acute coronary syndrome (ACS) (n=402). Short physical performance battery (SPPB) vs. Baseline characteristics and GRACE/TIMI risk scores alone was evaluated on Major adverse cardiac events (cardiac death, reinfarction, and cerebrovascular accident [MACCE]) (ΔC-statistic 0.043, p=0.04). The addition of the short physical performance battery (SPPB) to baseline characteristics significantly improved the prediction of 1-year MACCE (ΔC-statistic 0.043, p=0.04) in older ACS patients.