Department of Cardiology, Faculty of Medicine, Cukurova University, Adana, Turkey.
Department of Biostatistics, Faculty of Medicine, Cukurova University, Adana, Turkey.
Braz J Cardiovasc Surg. 2020 Dec 1;35(6):897-905. doi: 10.21470/1678-9741-2019-0484.
Frailty is a condition of elderly characterized by increased vulnerability to stressful events. Frail patients are more likely to have adverse events. The purposes of this study were to define frailty in patients aged ≥ 70 years with chronic coronary syndrome (CCS) and to evaluate mortality and prognostic significance of frailty in these patients.
We included 99 patients, ≥ 70 years old (mean age 74±5.3 years), with diagnosis of CCS. They were followed-up for up to 12 months. The frailty score was evaluated according to the Canadian Study of Health and Aging (CSHA). All patients were divided as frail or non-frail. The groups were compared for their characteristics and clinical outcomes.
Fifty patients were classified as frail, and 49 patients as non-frail. The 12-month Major Adverse Cardiac Events (MACE) rate was 69.4% in frail patients and 20% in non-frail patients. Frailty increases the risk for MACE as much as 3.48 times. Two patients died in the non-frail group and 11 patients died in the frail group. Frailty increases the risk for death as much as 6.05 times. When we compared the aforementioned risk factors by multivariate analysis, higher CSHA frailty score was associated with increased MACE and death (relative risk [RR] = 22.94, 95% confidence interval [CI] 3.33-158.19, P=0.001, for MACE; RR = 7.41, 95% CI 1.44-38.03, P=0.016, for death).
Being a frail elderly CCS patient is associated with worse outcomes. Therefore, frailty score should be evaluated for elderly CCS patients as a prognostic marker.
衰弱是老年人的一种特征，表现为对压力事件的易感性增加。衰弱患者更有可能发生不良事件。本研究的目的是定义患有慢性冠状动脉综合征（CCS）的≥70 岁患者的衰弱，并评估这些患者的衰弱与死亡率和预后意义。
我们纳入了 99 名≥70 岁（平均年龄 74±5.3 岁）、CCS 诊断的患者。对他们进行了长达 12 个月的随访。根据加拿大健康与老龄化研究（CSHA）评估衰弱评分。所有患者均分为衰弱或非衰弱。比较两组的特征和临床结局。
50 例患者被归类为衰弱，49 例患者为非衰弱。衰弱患者 12 个月时主要不良心脏事件（MACE）发生率为 69.4%，而非衰弱患者为 20%。衰弱使 MACE 的风险增加了 3.48 倍。非衰弱组有 2 例死亡，衰弱组有 11 例死亡。衰弱使死亡风险增加了 6.05 倍。当我们通过多变量分析比较上述危险因素时，较高的 CSHA 衰弱评分与 MACE 和死亡增加相关（相对风险 [RR] = 22.94，95%置信区间 [CI] 3.33-158.19，P=0.001，用于 MACE；RR = 7.41，95% CI 1.44-38.03，P=0.016，用于死亡）。
作为一名衰弱的老年 CCS 患者，预后更差。因此，应将衰弱评分作为老年 CCS 患者的预后标志物进行评估。
