Navarro-Navajas Alberto, Narvaéz-Orozco Alejandro, Aguirre-Acevedo Daniel Camilo, Pabón-De Ossa David, Angarita-Vasquez Valentina, Ortiz-Uribe Juan Camilo, Delgado-Restrepo Juan Andrés, Senior-Sánchez Juan Manuel
Servicio de Hemodinamia, Unidad Funcional Integrada Cardiopulmonar, Hospital Universitario San Vicente Fundación, Medellín, Colombia. Servicio de Hemodinamia Unidad Funcional Integrada Cardiopulmonar Hospital Universitario San Vicente Fundación Medellín Colombia.
Sección de Cardiología, departamento de Medicina Interna, Universidad de Antioquia, Medellín, Colombia. Universidad de Antioquia Sección de Cardiología departamento de Medicina Interna Universidad de Antioquia Medellín Colombia.
Arch Peru Cardiol Cir Cardiovasc. 2024 Sep 29;5(3):124-131. doi: 10.47487/apcyccv.v5i3.408. eCollection 2024 Jul-Sep.
Several studies have demonstrated an association between frailty and worse outcomes in patients with acute coronary syndrome (ACS); however, there is a lack of evidence from Colombia. This study aims to evaluate the association between frailty and the risk of adverse outcomes in patients over 65 years old diagnosed with ACS.
A prospective cohort study was conducted, including patients over 65 years old who underwent coronary angiography due to an ACS diagnosis at a hospital in Medellín, Colombia. Frailty was assessed using the FRAIL scale. The primary outcome was all-cause mortality at 30 days. Secondary outcomes included length of hospital stay and a composite outcome of in-hospital or 30-day mortality, contrast-induced nephropathy (CIN), acute heart failure, cardiogenic shock, hemorrhagic complications, and vascular complications.
A total of 112 patients were included. Frail patients (n=35, 31.3%) were older, had a lower socioeconomic status, higher GRACE scores, and more severely compromised coronary vessels. A significant association was observed between frailty and 30-day mortality (relative risk [RR] 19.00, 95% confidence interval [CI]: 5.04-72.61; p<0.001), the composite outcome (RR 4.57, 95% CI: 2.56-8.34; p<0.001), and longer hospital stays (9 days vs. 5 days in the non-frail group).
A considerable number of patients over 65 years old with ACS were frail. Frailty was associated with adverse in-hospital and 30-day outcomes.
多项研究表明，急性冠状动脉综合征（ACS）患者的虚弱与更差的预后相关；然而，哥伦比亚缺乏相关证据。本研究旨在评估65岁以上诊断为ACS的患者中虚弱与不良预后风险之间的关联。
进行了一项前瞻性队列研究，纳入了哥伦比亚麦德林一家医院因ACS诊断而接受冠状动脉造影的65岁以上患者。使用FRAIL量表评估虚弱情况。主要结局是30天全因死亡率。次要结局包括住院时间以及住院或30天死亡率、造影剂肾病（CIN）、急性心力衰竭、心源性休克、出血并发症和血管并发症的复合结局。
共纳入112例患者。虚弱患者（n = 35，31.3%）年龄更大，社会经济地位更低，GRACE评分更高，冠状动脉血管受损更严重。观察到虚弱与30天死亡率（相对风险[RR] 19.00，95%置信区间[CI]：5.04 - 72.61；p < 0.001）、复合结局（RR 4.57，95% CI：2.56 - 8.34；p < 0.001）以及更长的住院时间（非虚弱组为5天，虚弱组为9天）之间存在显著关联。
相当数量的65岁以上ACS患者存在虚弱情况。虚弱与住院期间及30天的不良结局相关。
