Frailty and subclinical coronary atherosclerosis: The Multicenter AIDS Cohort Study (MACS)

Korada, Sai Krishna C.; Zhao, Di; Tibuakuu, Martin; Brown, Todd T.; Jacobson, Lisa P.; Güallar, Eliseo; Bolan, Robert; Palella, Frank J.; Margolick, Joseph B.; Martinson, Jeremy; Budoff, Matthew J.; Post, Wendy S.; Michos, Erin D.

doi:10.1016/j.atherosclerosis.2017.08.026

Cited by 19 publications

(14 citation statements)

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“…Muscle mass is weakly correlated with muscle strength in MACS, 15 and muscle weakness is an component of frailty, 35 which in turn is an important prognostic marker of CVD and mortality among older adults and adults with HIV-infection. 36-38 Defining frailty by the Fried phenotype, 35 MACS found that HIV-infected men aged 50-69 were significantly more likely to be frail compared to similarly-aged HIV-uninfected men, 21, 22 and frail HIV-infected men had higher levels of inflammatory markers and immune activation compared to nonfrail HIV-infected men. 39 Frailty by the Fried definition was associated with subclinical coronary atherosclerosis in MACS, but only among HIV-uninfected men.…”

Section: Discussionmentioning

confidence: 99%

“…39 Frailty by the Fried definition was associated with subclinical coronary atherosclerosis in MACS, but only among HIV-uninfected men. 22…”

Section: Discussionmentioning

confidence: 99%

“…Muscle weakness (as part of the frailty definition) has been defined in the MACS as dynamometer-measured grip strength <20 th percentile of HIV-uninfected men. 21, 22 To mirror this definition, participants with total areas of thigh muscle mass <20th percentile of the HIV-uninfected men in this sample were also classified as having low muscle mass, corresponding to <124.6 cm 2 . We also examined thigh muscle mass as a continuous variable per 1 standard deviation (SD) lower value.…”

Section: Methodsmentioning

confidence: 99%

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Low thigh muscle mass is associated with coronary artery stenosis among HIV-infected and HIV-uninfected men: The Multicenter AIDS Cohort Study (MACS)

Tibuakuu

Zhao

Saxena

et al. 2018

Journal of Cardiovascular Computed Tomography

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In this exploratory analysis, low thigh muscle mass was significantly associated with subclinical obstructive coronary stenosis. Additional studies involving larger sample sizes and prospective analyses are needed to confirm the potential utility of measuring mid-thigh muscle mass for identifying individuals at increased risk for obstructive CAD who might benefit from more aggressive risk factor management.

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Section: Discussionmentioning

confidence: 99%

“…39 Frailty by the Fried definition was associated with subclinical coronary atherosclerosis in MACS, but only among HIV-uninfected men. 22…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Low thigh muscle mass is associated with coronary artery stenosis among HIV-infected and HIV-uninfected men: The Multicenter AIDS Cohort Study (MACS)

Tibuakuu

Zhao

Saxena

et al. 2018

Journal of Cardiovascular Computed Tomography

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“…The detailed measurement protocols and definitions for all of these covariates have been previously published. [3,8,31] Statistical analysis: All results were presented for the overall cohort, and then stratified by HIV sero-status.…”

Section: Covariatesmentioning

confidence: 99%

GlycA, a novel inflammatory marker, is associated with subclinical coronary disease

Tibuakuu

Fashanu²,

Zhao

et al. 2019

Aids

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CVD ancillary study, was involved in the CT data collection, and provided critical revisions to the paper. Dr. Budoff interpreted the cardiac CT scans for the study (CT Core Lab) and provided critical revisions to the paper. Dr. Otvos provided the GlycA measurements and provided critical revisions to the paper. Drs. Zhao, Brown, Guallar, Palella, Martinson, Akinkuolie, Haberlen, and Mora provided critical revisions to the paper. Dr. Michos, Fashanu, and Tibuakuu take full responsibility for its content. All authors reviewed the final draft and approve of its submission. The manuscript was also approved by the MACS Executive Committee. Disclosures: Dr. Brown has served as a consultant to Gilead Sciences, Merck, BMS, EMD-Serono, and Theratechnologies. Dr. Budoff has received research funds from GE Healthcare. Dr. Otvos is employed by LabCorp (formally LipoScence). Dr. Mora has received research grant support from Atherotech Diagnostics, and has received consulting fees from Quest Diagnostics for work outside the current study. Dr. Mora has a patent application on the use of GlycA for predicting risk of colorectal cancer. No other authors report any conflicts.

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“…Although research shows that there are associations between frailty and CVD, few studies examine the associations between CHD diagnoses and frailty, particularly in older adults [17]. Little is known about the relationship between frailty and in-hospital mortality and readmission rates in hospitalized older patients with CHD.…”

mentioning

confidence: 99%

Hospital readmission and mortality: associations to a hospital frailty risk score in a national sample of US older adults with pre-existing coronary heart disease, an observational study.

Davis–Ajami¹,

Chang²,

Wu³

2020

Preprint

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Background Coronary heart disease (CHD) is the most common form of heart disease and a leading cause of death in cardiovascular disease (CVD). Although frailty has been studied in CVD, a condition encompassing heart disease and stroke, frailty in hospitalized elders with CHD is under researched. The study aimed to examine how a Hospital Frailty Risk Score (HFRS) influenced readmission and in-hospital mortality rates in older patients with CHD.Methods Adults > 65 years with pre-existing CHD identified by ICD-10-CM codes from the 2016 Nationwide Readmissions Database (NRD) were included in the study. Frailty risk was determined using a validated Hospital Frailty Risk Score (HFRS) based on ICD-10-CM codes. Readmission was defined as a) any subsequent inpatient readmission and b) 30-day readmission after an index event. In-hospital mortality was measured as death during index event, any readmission death, and death during a 30-day readmission.Results Frailty risk was identified in 92.4% of the 1.09 million eligible adults with CHD. Readmission and in-hospital mortality rates were higher in frail patients. Compared to the non-frail, patients with low, intermediate, and high frailty risk showed 27% vs 28%, 47% vs 49%, and 42% vs 49% greater risk for readmission and 30-day readmission, respectively. Patients with intermediate and high frailty risk were 2.31 and 3.44 times more likely to die during the index events, 2.15 and 2.44 times more likely to die during readmission, and 2.26 and 2.68 times more likely to die during 30-day readmission.Conclusion Readmission and mortality rates increased proportionally to the level of frailty risk in older adults with CHD. CHD, frailty, and older age together profoundly impact patients’ health outcomes in negative ways and places patients at a higher risk of mortality and readmission rate than non-frail patients. Further research should investigate interventions to improve frailty risk in CHD.

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Frailty and subclinical coronary atherosclerosis: The Multicenter AIDS Cohort Study (MACS)

Cited by 19 publications

References 43 publications

Low thigh muscle mass is associated with coronary artery stenosis among HIV-infected and HIV-uninfected men: The Multicenter AIDS Cohort Study (MACS)

Low thigh muscle mass is associated with coronary artery stenosis among HIV-infected and HIV-uninfected men: The Multicenter AIDS Cohort Study (MACS)

GlycA, a novel inflammatory marker, is associated with subclinical coronary disease

Hospital readmission and mortality: associations to a hospital frailty risk score in a national sample of US older adults with pre-existing coronary heart disease, an observational study.

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