Prognosis impact of frailty assessed by the Edmonton Frail Scale in the setting of acute coronary syndrome in the elderly

Blanco, Stéphane; Ferrières, Jean; Bongard, Vanina; Toulza, Olivier; Sebai, F.; Billet, Sophie; Biendel, Caroline; Lairez, Olivier; Lhermusier, Thibault; Boudou, Nicolas; Campelo‐Parada, Francisco; Roncalli, Jérôme; Galinier, Michel; Carrié, Didier; Elbaz, Meyer; Bouisset, Frédéric

doi:10.1016/j.acvdsp.2017.11.019

Cited by 8 publications

(10 citation statements)

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“…As expected, they were more often women with more cardiovascular risk factors such as hypertension and diabetes mellitus, and worse clinical status and geriatric conditions at baseline. Such findings are in accordance with previous studies including elderly patients with ACS, in which frailty was closely associated with higher comorbidity and worse prognosis 20 . Accordingly, in this scenario, some cardiovascular and clinical factors such as previous cardiovascular disease and a higher Killip class on admission, as well as lower hemoglobin levels, entail, when present, worse prognosis in elderly ACS patients.…”

Section: Discussionsupporting

confidence: 92%

Baseline CHA ₂ DS ₂ ‐VASc score and prognosis in octogenarians with non‐ST segment elevation acute coronary syndrome

et al. 2021

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Background CHA2DS2‐VASc Score is widely used to predict thromboembolic risk in patients with Atrial Fibrillation (AF). We sought to study if this score predicts outcomes in elderly patients with Non‐ST segment Elevation Acute Coronary Syndromes (NSTEACS). Methods The multicenter LONGEVO‐SCA prospective registry included 532 unselected patients with NSTEACS aged ≥80 years. Data to calculate CHA2DS2‐VASc Score were available in 523 patients (98.3%). They were classified according to CHA2DS2‐VASc Score: group 1 (score ≤ 4), and 2 (5‐9). We studied outcomes in terms of mortality or readmission at 6 months follow‐up. Results A total of 266 patients (51%) had a high CHA2DS2‐VASc Score (group 2). They were more often women, with more cardiovascular risk factors, such as hypertension or diabetes mellitus, and history of previous stroke and cardiovascular disease and heart failure (all, P = .001). Geriatric syndromes (Barthel Index, Lawton Brody, cognitive impairment, and frailty) and Charlson Index were worse in this group (all, P = .001). They had poorer clinical status on admission, with worse Killip class and lower left ventricle ejection fraction (all, P = .001), and developed new‐onset AF more often during admission (12.4% vs. 6.6%, P = .024). At six months follow‐up, patients in group 2 had higher reinfarction, all‐cause mortality, and mortality or readmission rates. A CHA2DS2‐VASc Score > 4 was associated with mortality or readmission at 6 months (HR 2.07, P < .001). However, after adjusting for potential confounders, this last association was not significant (P = .175). Conclusions A CHA2DS2‐VASc Score > 4 is present in half of octogenarians with NSTEACS and is associated with poorer outcomes. However, it is not an independent predictor of events and should not replace recommended tools for risk prediction in this setting.

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Section: Discussionsupporting

confidence: 92%

Baseline CHA ₂ DS ₂ ‐VASc score and prognosis in octogenarians with non‐ST segment elevation acute coronary syndrome

et al. 2021

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“…The causes of death are shown in Table 3. 19,20 which are useful for predicting outcomes. However, it can be difficult to evaluate these parameters in the emergency setting.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Influence of Preadmission Frailty on Short- and Mid-Term Prognoses in Octogenarians With ST-Elevation Myocardial Infarction

Yoshioka

Takagi

Morishima

et al. 2019

Circ J

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STEMI receiving PCI has not been evaluated sufficiently with regard to overall mortality and non-home discharge. The aim of this study was to evaluate the association of CFS with these clinical outcomes of octogenarian patients with STEMI. Methods Study Design and Population We screened the Nagoya multicenter registry for the data of consecutive patients with STEMI who underwent primary PCI between January 2014 and December 2016 (n=1,301). The registry is an ongoing, retrospective, multicenter registry of coronary artery disease and current data include information from 5 institutions in the Tokai area, details of which have been described previously. 10 Of the

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“…During the last decade, the assessment of frailty, disability, comorbidity and cognitive impairment has received a growing interest. [24][25][26][27][28][29][30][31][32][33][34] The presence of these factors has been proposed as a potential reason for the suboptimal ability of the bleeding risk scores in elderly patients with ACS. 8 No study has assessed the role of a comprehensive geriatric assessment in bleeding risk stratification of patients with ACS at older ages.…”

Section: Discussionmentioning

confidence: 99%

“…• The functional capacity for basic activities of daily living was assessed by the Barthel index. 14 This is an ordinal scale with a total score of 0 to 100, where the intermediate ranges help evaluate the different degrees of dependency: total (0-20), severe (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40), moderate (41-60), light (61-90) and independent (> 90). Instrumental activities were evaluated with the Lawton-Brody index.…”

Section: Baseline Geriatric Assessmentmentioning

confidence: 99%

Global Geriatric Assessment and In-Hospital Bleeding Risk in Elderly Patients with Acute Coronary Syndromes: Insights from the LONGEVO-SCA Registry

Arizá-Solé¹,

Guerrero²,

Formiga³

et al. 2018

Thromb Haemost

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Background Bleeding risk scores have shown a limited predictive ability in elderly patients with acute coronary syndromes (ACS). No study explored the role of a comprehensive geriatric assessment to predict in-hospital bleeding in this clinical setting. Methods The prospective multicentre LONGEVO-SCA registry included 532 unselected patients with non-ST segment elevation ACS (NSTEACS) aged 80 years or older. Comorbidity (Charlson index), frailty (FRAIL scale), disability (Barthel index and Lawton–Brody index), cognitive status (Pfeiffer test) and nutritional risk (mini nutritional assessment-short form test) were assessed during hospitalization. CRUSADE score was prospectively calculated for each patient. In-hospital major bleeding was defined by the CRUSADE classification. The association between geriatric syndromes and in-hospital major bleeding was assessed by logistic regression method and the area under the receiver operating characteristic curves (AUC). Results Mean age was 84.3 years (SD 4.1), 61.7% male. Most patients had increased troponin levels (84%). Mean CRUSADE bleeding score was 41 (SD 13). A total of 416 patients (78%) underwent an invasive strategy, and major bleeding was observed in 37 cases (7%). The ability of the CRUSADE score for predicting major bleeding was modest (AUC 0.64). From all aging-related variables, only comorbidity (Charlson index) was independently associated with major bleeding (per point, odds ratio: 1.23, p = 0.021). The addition of comorbidity to CRUSADE score slightly improved the ability for predicting major bleeding (AUC: 0.68). Conclusion Comorbidity was associated with major bleeding in very elderly patients with NSTEACS. The contribution of frailty, disability or nutritional risk for predicting in-hospital major bleeding was marginal.

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Prognosis impact of frailty assessed by the Edmonton Frail Scale in the setting of acute coronary syndrome in the elderly

Cited by 8 publications

References 0 publications

Baseline CHA ₂ DS ₂ ‐VASc score and prognosis in octogenarians with non‐ST segment elevation acute coronary syndrome

Baseline CHA ₂ DS ₂ ‐VASc score and prognosis in octogenarians with non‐ST segment elevation acute coronary syndrome

Influence of Preadmission Frailty on Short- and Mid-Term Prognoses in Octogenarians With ST-Elevation Myocardial Infarction

Global Geriatric Assessment and In-Hospital Bleeding Risk in Elderly Patients with Acute Coronary Syndromes: Insights from the LONGEVO-SCA Registry

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Prognosis impact of frailty assessed by the Edmonton Frail Scale in the setting of acute coronary syndrome in the elderly

Cited by 8 publications

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Baseline CHA 2 DS 2 ‐VASc score and prognosis in octogenarians with non‐ST segment elevation acute coronary syndrome

Baseline CHA 2 DS 2 ‐VASc score and prognosis in octogenarians with non‐ST segment elevation acute coronary syndrome

Influence of Preadmission Frailty on Short- and Mid-Term Prognoses in Octogenarians With ST-Elevation Myocardial Infarction

Global Geriatric Assessment and In-Hospital Bleeding Risk in Elderly Patients with Acute Coronary Syndromes: Insights from the LONGEVO-SCA Registry

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Product

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Baseline CHA ₂ DS ₂ ‐VASc score and prognosis in octogenarians with non‐ST segment elevation acute coronary syndrome

Baseline CHA ₂ DS ₂ ‐VASc score and prognosis in octogenarians with non‐ST segment elevation acute coronary syndrome