Frailty is independently associated with 1-year mortality for elderly patients with non-ST-segment elevation myocardial infarction
Frailty is independently associated with 1-year mortality for elderly patients with non-ST-segment elevation myocardial infarction
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DOI：
10.1177/2047487313490257
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发表时间：
2014-10-01
影响因子：
8.3
通讯作者：
Carlsson, Per
中科院分区：
文献类型：
--
作者：
Ekerstad, Niklas;Swahn, Eva;Carlsson, Per
背景：对于大量老年心血管疾病患者，确定临床相关的生物年龄及其对风险的贡献至关重要。脆弱是指生理储备的减少和脆弱性的增加。我们分析了可变虚弱与老年非st段抬高型心肌梗死（NSTEMI）患者1年预后相关的方式。方法和结果纳入三个中心的75岁及以上确诊为NSTEMI的患者，前瞻性收集包括虚弱判断在内的临床资料。虚弱是根据加拿大健康与衰老临床虚弱量表定义的。307例患者中，149例（48.5%）体弱多病。通过Cox回归分析，在调整心血管风险和合并症后，发现虚弱与1年死亡率独立相关（风险比4.3,95% CI 2.4-7.8）。体弱患者发生第一次事件的时间明显短于非体弱患者（34天，95% CI 10-58, p=0.005）。结论：虚弱与1年死亡率有强烈且独立的相关性。对于有复杂需求的心血管患者，虚弱和合并症的联合使用可能构成一个重要的风险预测概念。
Background For the large population of elderly patients with cardiovascular disease, it is crucial to identify clinically relevant measures of biological age and their contribution to risk. Frailty is denoting decreased physiological reserves and increased vulnerability. We analysed the manner in which the variable frailty is associated with 1-year outcomes for elderly non-ST-segment elevation myocardial infarction (NSTEMI) patients.Methods and Results Patients aged 75 years or older, with diagnosed NSTEMI were included at three centres, and clinical data including judgment of frailty were collected prospectively. Frailty was defined according to the Canadian Study of Health and Aging Clinical Frailty Scale. Of 307 patients, 149 (48.5%) were considered frail. By Cox regression analyses, frailty was found to be independently associated with 1-year mortality after adjusting for cardiovascular risk and comorbid conditions (hazard ratio 4.3, 95% CI 2.4-7.8). The time to the first event was significantly shorter for frail patients than for nonfrail (34 days, 95% CI 10-58, p=0.005).Conclusions Frailty is strongly and independently associated with 1-year mortality. The combined use of frailty and comorbidity may constitute an important risk prediction concept in regard to cardiovascular patients with complex needs.