TY - JOUR 
A1 - Alegre, Oriol
AU - Formiga, Francesc
AU - López Palop, Ramón
AU - Marín, Francisco
AU - Vidán, María Teresa
AU - Martínez Sellés Oliveria Soares, Manuel
AU - Carol, Antoni
AU - Sionis, Alessandro
AU - Díez Villanueva, Pablo
AU - Salterain González, Nahikari
AU - Et al.
T1 - An easy assessment of frailty at baseline independently predicts prognosis in very elderly patients with acute coronary syndromes
Y1 - 2018
SN - 1525-8610
UR - http://hdl.handle.net/11268/7262
AB - Background:
Information about the impact of frailty in patients with acute coronary syndromes (ACS) is scarce. No study has assessed the prognostic impact of frailty as measured by the FRAIL scale in very elderly patients with ACS.

Methods:
The prospective multicenter LONGEVO-SCA registry included unselected patients with ACS aged 80 years or older. A comprehensive geriatric assessment was performed during hospitalization, including frailty assessment by the FRAIL scale. The primary endpoint was mortality at 6 months.

Results:
A total of 532 patients were included. Mean age was 84.3 years, 61.7% male. Most patients had positive troponin levels (84%) and high GRACE risk score values (mean 165). A total of 205 patients were classified as prefrail (38.5%) and 145 as frail (27.3%). Frail and prefrail patients had a higher prevalence of comorbidities, lower left ventricle ejection fraction, and higher mean GRACE score value. A total of 63 patients (11.8%) were dead at 6 months. Both prefrailty and frailty were associated with higher 6-month mortality rates (P < .001). After adjusting for potential confounders, this association remained significant (hazard ratio [HR] 2.71; 95% confidence interval [CI] 1.09–6.73 for prefrailty and HR 2.99; 95% CI 1.20–7.44 for frailty, P = .024). The other independent predictors of mortality were age, Charlson Index, and GRACE risk score.

Conclusions:
The FRAIL scale is a simple tool that independently predicts mortality in unselected very elderly patients with ACS. The presence of prefrailty criteria also should be taken into account when performing risk stratification of these patients.
KW - Cardiopatía coronaria
KW - Ancianos
KW - Enfermedad cardiovascular
KW - Anciano
LA - eng
ER -