Fast systematic geriatric assessment in acute heart failure patients admitted in Cardiology

Aguilar-Iglesias, Lara; Merino-Merino, Ana; Sanchez-Corral, E; Garcia-Sanchez, Maria-Jesus; Santos-Sanchez, Isabel; Dominguez-Calvo, Jesus; Saez-Maleta, Ruth; Rivera, Jaime A.

doi:10.1016/j.hrtlng.2023.03.015

Cited by 4 publications

(3 citation statements)

References 28 publications

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“…Of the included studies, 13 studies were considered of having a high risk of bias [ 7 , 31 , 32 , 39 , 41 , 43 , 46 , 52 , 53 , 60 , 61 , 63 , 64 ], 16 as moderate risk of bias [ 18 , 29 , 33 , 36 , 37 , 42 , 44 , 45 , 48 – 50 , 55 , 56 , 58 , 59 , 62 ], and 12 studies had a low risk [ 28 , 30 , 34 , 35 , 38 , 40 , 47 , 51 , 54 , 57 , 65 , 66 ] (Table S2).…”

Section: Resultsmentioning

confidence: 99%

Association between natriuretic peptides and C-reactive protein with frailty in heart failure: a systematic review and meta-analysis

Prokopidis,

Ishiguchi,

Jordan

et al. 2024

Aging Clin Exp Res

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Background Heart failure (HF) and frailty are accompanied by a bidirectional relationship, sharing common risk factors including elevated levels of natriuretic peptides and inflammation. The aim of this study was to compare biomarkers associated with poor clinical outcomes, that is, plasma brain natriuretic peptide (BNP), N-terminal-pro B-type natriuretic peptide (NT-proBNP), and C-reactive protein (CRP) in patients with HF and frailty vs. patients with HF without frailty. Methods From inception until July 2023, PubMed, Scopus, Web of Science, and Cochrane Library a systematic literature search was conducted. To evaluate whether frailty is linked with greater levels of BNP, NT-proBNP, and CRP, a meta-analysis using a random-effects model was used to calculate the pooled effects (CRD42023446607). Results Fifty-three studies were included in this systematic review and meta-analysis. Patients with HF and frailty displayed significantly higher levels of BNP (k = 11; SMD: 0.53, 95%CI 0.30–0.76, I2 = 86%, P < 0.01), NT-proBNP (k = 23; SMD: 0.33, 95%CI 0.25–0.40, I2 = 72%, P < 0.01), and CRP (k = 8; SMD: 0.30, 95%CI 0.12–0.48, I2 = 62%, P < 0.01) vs. patients with HF without frailty. Using meta-regression, body mass index (BMI) and age were deemed potential moderators of these findings. Conclusions Frailty in HF is linked to increased concentrations of BNP, NT-proBNP, and CRP, which have been epidemiologically associated with adverse outcomes. The increased risk of NYHA III/IV classification further emphasizes the clinical impact of frailty in this population.

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Section: Resultsmentioning

confidence: 99%

Association between natriuretic peptides and C-reactive protein with frailty in heart failure: a systematic review and meta-analysis

Prokopidis,

Ishiguchi,

Jordan

et al. 2024

Aging Clin Exp Res

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“… 37 Another possible underlying mechanism is the worse prognosis usually associated with comorbidities that are also more frequent in frail and dependent patients. 20 …”

Section: Discussionmentioning

confidence: 99%

“…We have decided to include pre‐frail patients in the non‐frail group because these patients have not yet developed the characteristics of the vulnerability of a frail patient, although they are at higher risk. 20 All grades of dependence are included in the dependent group of patients (light, moderate, and severe dependence).…”

Section: Methodsmentioning

confidence: 99%

Prognostic effect of systematic geriatric assessment on patients with acute heart failure

Aguilar‐Iglesias,

Merino‐Merino,

Sanchez‐Corral

et al. 2024

ESC Heart Failure

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AimsFrailty and dependence are frequent in patients admitted for acute heart failure (AHF), but their prognostic significance is unknown, especially in young adults. We aimed to study in adults admitted for AHF, regardless of age, the effect of frailty and dependence on the incidence of mortality and a combined event of mortality, readmissions for AHF, and visits to the emergency room (ER) for AHF at 1 and 6 months.Methods and resultsWe designed a prospective cohort study by including all the patients with AHF admitted in our Cardiology Department from July 2020 through May 2021. A multidimensional geriatric assessment was performed during the admission. We clinically followed up the patients 6 months after discharge. We enrolled 202 patients. The mean age was 73 ± 12.32 years, and 100 (49.5%) of the patients were elderly (>75 years). Just 78 patients (38.6%) were women, and 100 (49.5%) had previous HF. Frailty (FRAIL ≥ 3) was observed in 68 (33.7%) patients (mean FRAIL score: 1.88 ± 1.48). Dependence (Barthel < 100) was observed in 65 (32.2%) patients (mean Barthel index: 94.38 ± 11.21). Frailty and dependence showed a significant association with both prognostic events at 1 and 6 months. In the multivariable analysis, frailty was associated with higher mortality at 1 month [hazard ratio (HR) 12.61, 95% confidence interval (CI) 1.57–101.47, P = 0.017] but not at 6 months (HR 2.25, 95% CI 0.61–8.26, P = 0.224) or with the combined endpoint at neither 1 month (HR 1.64, 95% CI 0.54–5.03, P = 0.384) nor 6 months (HR 1.35, 95% CI 0.75–2.46, P = 0.320). Dependence was related to higher mortality at 1 month (HR 13.04, 95% CI 1.62–104.75, P = 0.016) and 6 months (HR 7.18, 95% CI 1.99–25.86, P = 0.003) and to higher incidence of the combined event at 1 month (HR 5.93, 95% CI 1.63–21.50, P = 0.007) and 6 months (HR 2.62, 95% CI 1.49–4.61, P = 0.001).ConclusionsIn AHF patients, frailty and dependence implied a worse prognosis, rising mortality, readmissions, and ER visits for AHF.

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Impact of Frailty on Heart Failure Prognosis: Is Sex Relevant?

Aguilar-Iglesias,

Perez-Asensio,

Vilches-Miguel

et al. 2024

Curr Heart Fail Rep

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Fast systematic geriatric assessment in acute heart failure patients admitted in Cardiology

Cited by 4 publications

References 28 publications

Association between natriuretic peptides and C-reactive protein with frailty in heart failure: a systematic review and meta-analysis

Association between natriuretic peptides and C-reactive protein with frailty in heart failure: a systematic review and meta-analysis

Prognostic effect of systematic geriatric assessment on patients with acute heart failure

Impact of Frailty on Heart Failure Prognosis: Is Sex Relevant?

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