Utility of Frailty Assessment for Elderly Patients Undergoing Cardiac Resynchronization Therapy

Kubala, Maciej; Guédon‐Moreau, Laurence; Anselme, Frédéric; Klug, Didier; Bertaina, Geneviève; Traullé, Sarah; Buiciuc, Otilia; Savouré, Arnaud; Hermida, Jean‐Sylvain

doi:10.1016/j.jacep.2017.06.012

Cited by 30 publications

(30 citation statements)

References 46 publications

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“…In LVAD-independent frailty, multiple organ impairment is the major underlying prognostic determinant and LVAD implantation may be less likely to result in significant improvement. The potential of HF therapies to Bde-frailp atients is currently being evaluated in prospective studies [53,54].…”

Section: Future Directionsmentioning

confidence: 99%

Prognostic and Therapeutic Implications of Frailty in Older Adults with Heart Failure

2015

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Frailty is increasingly recognized in older adults with cardiovascular disease, particularly in those with heart failure (HF). A growing body of evidence has shown that frailty has a negative effect on survival, hospitalizations, disability, and quality of life. Beyond frailty, additional domains captured by a comprehensive geriatric assessment contribute incremental value in predicting outcomes and identifying treatment targets. Exercise training is ideally suited to this setting as it can concomitantly improve physical frailty and HF symptoms. Multidisciplinary disease management programs offer a number of benefits for frail HF patients; invasive procedures carry a higher risk of morbidity than in non-frail counterparts, and evidence-based drugs and devices have an uncertain value and warrant further research. While more data accrues, difficult therapeutic decisions should be individualized using a shared patient-centered decision making approach.

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Section: Future Directionsmentioning

confidence: 99%

Prognostic and Therapeutic Implications of Frailty in Older Adults with Heart Failure

2015

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“…has not been evaluated. Fifth, frailty is an independent predictor of major cardiovascular adverse events in patients with HF treated with CRT [3,24]. Our study was not powered to assess statistical interactions between adherence to the MedDiet, frailty and cardiovascular adverse events.…”

Section: Study Limitationsmentioning

confidence: 97%

Adherence to Mediterranean diet and prognosis in older patients scheduled to undergo cardiac resynchronization therapy

Avanzas

Abreu-González

Báez-Ferrer

et al. 2020

Nutrition, Metabolism and Cardiovascular Diseases

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Background and aims: Adherence to the Mediterranean diet (MedDiet) has been associated with prolonged survival in older individuals. However, it is unknown whether adherence to MedDiet is associated with the prognosis in older patients scheduled to undergo cardiac resynchronization therapy (CRT). The aim of this study was to evaluate the association between adherence to the MedDiet and clinical outcomes at 12 months follow-up after CRT implantation in older patients. Methods and results: Patients adherents to the MedDiet, defined as ! 9 of 14 points using the PREDIMED (Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Study) questionnaire, was assessed before device implantation in patient's ! 70 years candidates for CRT. The primary outcome was a combined endpoint at 12 months follow-up after CRT implantation, defined as cardiovascular death, cardiac transplantation or decompensated heart failure. The cohort study consisted of 284 patients with a mean age of 73 AE 3 years. One hundred and fifty-nine (55.9%) patients were classified as adherent to the MedDiet. Seventy (24.6%) patients showed the combined endpoint at one year follow-up. Subjects who did not developed the combined endpoint had higher proportion of adherent patients to the MedDiet compared to patients who developed the combined endpoint (85% vs 67.1%, p Z 0.002). After adjustment by possible confounders, the adherence to the MedDiet was a protective and significant predictor of the combined endpoint (HR Z 0.42, 95% CI 0.22e0.81; p Z 0.01). Conclusion: Adherence to the MedDiet is inversely associated with outcome in older patients following CRT. jo urnal homep age: www.el sevie r.co m/locate/nm cd

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“…Frai lty is becoming an instrument more frequently used to decision-making in the therapeutic-diagnostic process in elderly patients suffering from speci ic pathologies. Frailty is certainly an independent predictor of non-response to CRT and a higher risk of hospitalization for HF and mortality [27]. On the other hand, there are few contrasting data regarding the association between frailty and device-based therapy [28].…”

Section: Biological and Chronological Age And The Concept Of Frailtymentioning

confidence: 99%

“…The problem is that it is dif icult to standardized criteria for de ine good life expectancy. Some authors have tried to create risk scores to predict mortality in ICD recipients [41].…”

Section: Importance Of Comorbidities In Patients With Indication To Icdmentioning

confidence: 99%

Primary prevention of SCD with ICD in the elderly

Gemelli¹,

Mancinelli²,

Protic³

et al. 2020

J Cardiol Cardiovasc Med

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Utility of Frailty Assessment for Elderly Patients Undergoing Cardiac Resynchronization Therapy

Cited by 30 publications

References 46 publications

Prognostic and Therapeutic Implications of Frailty in Older Adults with Heart Failure

Prognostic and Therapeutic Implications of Frailty in Older Adults with Heart Failure

Adherence to Mediterranean diet and prognosis in older patients scheduled to undergo cardiac resynchronization therapy

Primary prevention of SCD with ICD in the elderly

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