Prevalence and adverse outcomes of frailty in patients with acute myocardial infarction after Percutaneous Coronary Interventions: a systematic review and meta-analysis

Abstract

Objective To investigate the prevalence of frailty in patients with acute myocardial infarction after percutaneous coronary intervention and the relationship between frailty and adverse outcomes in patients with acute myocardial infarction after percutaneous coronary intervention. Methods We searched relevant studies published from database establishment to October 2021 and performed a meta-analysis using stata12.0 software. A random-effects model was used for I2 greater than > 50%; otherwise, a fixed-effects model was used. Results There were 274,976 elderly patients. The degree of frailty was assessed using different frailty assessment tools, the most common of which was the Frailty Index Scale. Nine studies investigated the prevalence of frailty in patients with acute myocardial infarction after PCI, with an overall prevalence of 39% (95% CI: 18%-60%, P < 0.001). Six studies included adverse outcomes in frail patients with acute myocardial infarction after PCI, including all-cause mortality (HR = 2.29, 95%CI:1.65–3.16, P = 0.285), re-hospitalization (HR = 2.53, 95% CI: 1.38–4.63), and in-hospital major bleeding (HR = 1.93, 95% CI: 1.29–2.90,P = 0.825). Conclusion In patients with acute myocardial infarction after PCI, the frailty prevalence is increased, especially in STEMI. Frailty patients after PCI, acute myocardial infarction is more likely to be associated with worse clinical outcomes, such as death, bleeding, and re-hospitalization.