Frailty as a predictor of all-cause mortality in elderly patients undergoing percutaneous coronary intervention: A systematic review and meta-analysis

He, Yun‐Yun; Chang, Jing; Wang, Xiaojuan

doi:10.1016/j.archger.2021.104544

Cited by 12 publications

(9 citation statements)

References 40 publications

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“…Additionally, traditional risk scoring systems in patients with CCD may need to be modified to most accurately assess an older patient’s risk. 32,33 Older patients also have an increased prevalence of frailty, 34–37 malnourishment, 38–41 and cognitive decline, all of which may be associated with poor outcomes and treatment response. Equally important, older patients are more likely to prioritize the ability to remain independent, with a focus on maintaining their mobility and functional status rather than reducing their mortality rate.…”

Section: Special Populationsmentioning

confidence: 99%

2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines

Virani,

Newby,

Arnold

et al. 2023

Circulation

398

112

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AIM The “2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease” provides an update to and consolidates new evidence since the “2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease” and the corresponding “2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease.” Methods A comprehensive literature search was conducted from September 2021 to May 2022. Clinical studies, systematic reviews and meta-analyses, and other evidence conducted on human participants were identified that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Structure This guideline provides an evidenced-based and patient-centered approach to management of patients with chronic coronary disease, considering social determinants of health and incorporating the principles of shared decision-making and team-based care. Relevant topics include general approaches to treatment decisions, guideline-directed management and therapy to reduce symptoms and future cardiovascular events, decision-making pertaining to revascularization in patients with chronic coronary disease, recommendations for management in special populations, patient follow-up and monitoring, evidence gaps, and areas in need of future research. Where applicable, and based on availability of cost-effectiveness data, cost–value recommendations are also provided for clinicians. Many recommendations from previously published guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.

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Section: Special Populationsmentioning

confidence: 99%

2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines

Virani,

Newby,

Arnold

et al. 2023

Circulation

398

112

View full text Add to dashboard Cite

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“…Additionally, increased cardiovascular disease burden and procedural complexity may elevate readmission risk. Last, frailty, an independent risk factor for incident ADRD, 6 confers higher risks for poor outcomes post‐PCI 7,8 …”

Section: Figurementioning

confidence: 99%

“…Last, frailty, an independent risk factor for incident ADRD, 6 confers higher risks for poor outcomes post-PCI. 7,8 People with ADRD and their care partners routinely face complex decisions before PCI regarding: employment and finances; where to live; who gives assistance with instrumental activities of daily living (including transportation and medication management) and activities of daily living; and whether to go to the emergency department or be admitted to the hospital. 9 To better define success, we need to first understand the person's values and what matters most to them, and then determine if the potential risks and benefits of PCI align with their values and health priorities (Figure 1).…”

mentioning

confidence: 99%

It is time to be heard and understood: Readmission probably is not the outcome that matters among people with dementia considering percutaneous coronary intervention

Bernacki

Krishnaswami

Don

2023

J American Geriatrics Society

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“…Frailty was associated with increased in-hospital mortality (OR 3.59, 95% CI 2.01–6.42), short-term mortality (OR 6.61, 95% CI 2.89–15.16), as well as long-term mortality (HR 3.24, 95% CI 2.04–5.14) in patients undergoing a PCI. Moreover, prefrailty was a predictor of all-cause mortality in senior patients undergoing a PCI [ 71 ]. Frailty also has a negative impact not only on mortality in old patients undergoing a PCI but also in hospital stay and time interval from admission to the PCI.…”

Section: Treatment Characteristics In the Fragile Senior Patient With...mentioning

confidence: 99%

Chronic Coronary Syndrome in Frail Old Population

Ilie

Țăranu

Ștefăniu

et al. 2022

Life

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The demographic trend of aging is associated with an increased prevalence of comorbidities among the elderly. Physical, immunological, emotional and cognitive impairment, in the context of the advanced biological age segment, leads to the maintenance and precipitation of cardiovascular diseases. Thus, more and more data are focused on understanding the pathophysiological mechanisms underlying each fragility phenotype and how they potentiate each other. The implications of inflammation, sarcopenia, vitamin D deficiency and albumin, as dimensions inherent in fragility, in the development and setting of chronic coronary syndromes (CCSs) have proven their patent significance but are still open to research. At the same time, the literature speculates on the interdependent relationship between frailty and CCSs, revealing the role of the first one in the development of the second. In this sense, depression, disabilities, polypharmacy and even cognitive disorders in the elderly with ischemic cardiovascular disease mean a gradual and complex progression of frailty. The battery of tests necessary for the evaluation of the elderly with CCSs requires a permanent update, according to the latest guidelines, but also an individualized approach related to the degree of frailty and the conditions imposed by it. By summation, the knowledge of frailty screening methods, through the use of sensitive and individualized tools, is the foundation of secondary prevention and prognosis in the elderly with CCSs. Moreover, a comprehensive geriatric assessment remains the gold standard of the medical approach of these patients. The management of the frail elderly, with CCSs, brings new challenges, also from the perspective of the treatment particularities. Sometimes the risk–benefit balance is difficult to achieve. Therefore, the holistic, individualized and updated approach of these patients remains a desired objective, by understanding and permanently acquiring knowledge on the complexity of the frailty syndrome.

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Frailty as a predictor of all-cause mortality in elderly patients undergoing percutaneous coronary intervention: A systematic review and meta-analysis

Cited by 12 publications

References 40 publications

2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines

2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines

It is time to be heard and understood: Readmission probably is not the outcome that matters among people with dementia considering percutaneous coronary intervention

Chronic Coronary Syndrome in Frail Old Population

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