Key result
Frailty and poor physical performance after AMI are linked to increased mortality and adverse cardiovascular events.
Why the study?
Physical performance and frailty have emerged as potential markers of physiological reserve and cardiovascular vulnerability after AMI, prompting a review of the prognostic significance, pathophysiological mechanisms, and clinical implications of gait speed, lower-extremity physical performance, frailty, and sarcopenia after AMI and ACS.
Does incorporating gait speed, SPPB, frailty, and sarcopenia assessments improve cardiovascular risk stratification and prognosis prediction in patients after acute myocardial infarction or acute coronary syndrome?
Does incorporating gait speed, SPPB, frailty, and sarcopenia assessments improve cardiovascular risk stratification and prognosis prediction in patients after acute myocardial infarction or acute coronary syndrome?
Incorporating objective physical performance and frailty assessments such as gait speed and SPPB into post-AMI evaluation provides incremental prognostic value beyond conventional risk scores and identifies vulnerable patients who may benefit from targeted cardiac rehabilitation.
Answers are grounded in this paper and cite their sources.
May inform post-AMI risk discussions with frailty measures; confirms associations and incremental value beyond conventional scores.
Purpose of Review Physical performance and frailty have emerged as potential markers of physiological reserve and cardiovascular vulnerability after acute myocardial infarction (AMI). This review examines the prognostic significance of gait speed, lower-extremity physical performance, frailty, and sarcopenia after AMI and acute coronary syndrome (ACS) and discusses their underlying pathophysiological mechanisms and clinical implications. Recent Findings Slow gait speed, impaired Short Physical Performance Battery (SPPB) scores, and frailty are associated with mortality, rehospitalization, heart failure, and adverse cardiovascular events after AMI or ACS. Gait speed and SPPB may provide incremental prognostic information beyond conventional cardiovascular risk assessment and established risk scores. These associations may reflect an interconnected cardiac–vascular–muscle axis involving reduced cardiac reserve, vascular dysfunction, impaired skeletal muscle perfusion, sarcopenia, and physical deconditioning. Importantly, emerging evidence suggests that targeted cardiac rehabilitation may improve gait speed, muscle strength, and overall physical performance in vulnerable patients. Summary Physical performance represents a clinically relevant and potentially modifiable dimension of post-AMI cardiovascular vulnerability. Incorporating gait speed, SPPB, and frailty assessment into conventional risk stratification may improve patient phenotyping and identify individuals requiring more intensive rehabilitation and follow-up. Further prospective studies are needed to standardize assessment strategies and determine whether improving physical performance translates into better cardiovascular outcomes.
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Goulart et al. (2026) conducted a review in Acute myocardial infarction and acute coronary syndrome. Impaired physical performance (slow gait speed, low Short Physical Performance Battery score, frailty, and sarcopenia) vs. Preserved physical performance and non-frail status was evaluated on Mortality, rehospitalization, heart failure, and adverse cardiovascular events. Slow gait speed, low Short Physical Performance Battery scores, and frailty after acute myocardial infarction are consistently associated with increased mortality and adverse cardiovascular events.
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