Coello Paul, Chaves Inti, Pacheco Paul, Alverca Fabricio, Garmendia Cristian M
Hospital Privado Modelo, Buenos Aires, Argentina. Hospital Privado Modelo Buenos Aires Argentina.
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Hospital Italiano de Buenos Aires Buenos Aires Argentina.
Arch Peru Cardiol Cir Cardiovasc. 2025 Feb 12;6(1):11-19. doi: 10.47487/apcyccv.v6i1.454. eCollection 2025 Jan-Mar.
To evaluate the prognostic role of functional status in older adults hospitalized for acute coronary syndrome (ACS) and the implications of the coronary event on functional decline during follow-up.
This was a single-center, prospective cohort study including patients aged ≥65 years hospitalized for ACS with (STEMI) or without ST-segment elevation in 2022. Patients with total dependence or lacking a care network were excluded. Functional status was assessed using the Barthel Index and the Lawton and Brody scales at admission, 30 days, and one year post-discharge. The association between initial functional status and major adverse cardiovascular events (MACE) was analyzed, as well as the impact of ACS on functional status over the short and long term.
A total of 110 patients older than 65 years were included (mean age 78.8±4.6 years; 61.8% male). At admission, 94.3% presented mild functional dependence according to the Barthel Index, with similar findings on the Lawton and Brody scales. At 30 days, a significant functional decline was observed (Barthel: 71.2±11.3, p<0.001; Lawton: 4.8±2.5, p=0.02), which persisted at one year. Initial functional status was not associated with MACE. ST-segment elevation ACS (STEMI) was an independent predictor of short-term functional decline (adjusted OR 1.75; p=0.04).
In older adults with ACS, initial functional status did not predict adverse events; however, significant functional decline was observed, particularly after STEMI. This underscores the importance of personalized strategies for managing this vulnerable population.
评估功能状态在因急性冠状动脉综合征（ACS）住院的老年人中的预后作用，以及冠状动脉事件对随访期间功能衰退的影响。
这是一项单中心前瞻性队列研究，纳入了2022年因ACS伴（ST段抬高型心肌梗死，STEMI）或不伴ST段抬高而住院的≥65岁患者。排除完全依赖他人或缺乏护理网络的患者。在入院时、出院后30天和1年使用巴氏指数以及Lawton和Brody量表评估功能状态。分析初始功能状态与主要不良心血管事件（MACE）之间的关联，以及ACS对短期和长期功能状态的影响。
共纳入110例65岁以上患者（平均年龄78.8±4.6岁；男性占61.8%）。入院时，根据巴氏指数，94.3%的患者存在轻度功能依赖，Lawton和Brody量表的结果相似。在30天时，观察到功能显著下降（巴氏指数：71.2±11.3，p<0.001；Lawton量表：4.8±2.5，p=0.02），这种下降在1年时仍然存在。初始功能状态与MACE无关。ST段抬高型ACS（STEMI）是短期功能衰退的独立预测因素（调整后的OR为1.75；p=0.04）。
在患有ACS的老年人中，初始功能状态不能预测不良事件；然而，观察到功能显著下降，尤其是在STEMI后。这凸显了针对这一脆弱人群制定个性化管理策略的重要性。
