One-year clinical events according to frailty in older patients with non-ST elevation acute coronary syndrome undergoing coronary angiography: an analysis of the IMPACT-TIMING-GO study.
10.26599/1671-5411.2025.01.003
- Author:
Pablo DÍEZ-VILLANUEVA
1
;
Pedro CEPAS-GUILLÉN
2
;
María Thiscal LÓPEZ LLUVA
3
;
Alfonso JURADO-ROMÁN
4
;
Pablo BAZAL-CHACÓN
5
;
Martín NEGREIRA-CAAMAÑO
6
;
Iván OLAVARRI-MIGUEL
7
;
Ane ELORRIAGA
8
;
Ricardo RIVERA-LÓPEZ
9
;
David ESCRIBANO
10
;
Pablo SALINAS
11
;
María MARTÍNEZ-AVIAL
1
;
Antonio MARTÍNEZ-GUISADO
2
;
Clea GONZÁLEZ-MANIEGA
3
;
Felipe DÍEZ-DELHOYO
6
Author Information
1. Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain.
2. Servicio de Cardiología, Hospital Clinic, Barcelona, Spain.
3. Servicio de Cardiología, Hospital Universitario de León, León, Spain.
4. Servicio de Cardiología, Hospital La Paz, Madrid, España IdiPaz (Instituto de Investigación Sanitaria del Hospital Universitario La Paz). Madrid, Spain.
5. Servicio de Cardiología, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain.
6. Servicio de Cardiología, Hospital Universitario.
7. Octubre, Madrid, Spain.
8. Servicio de Cardiología, Hospital Marqués de Valdecilla, Santander, Cantabria, Spain.
9. Servicio de Cardiología, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain.
10. Servicio de Cardiología, Hospital Virgen de las Nieves, Granada, Spain.
11. Servicio de Cardiología, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Spain.
- Publication Type:Journal Article
- From:
Journal of Geriatric Cardiology
2025;22(1):159-168
- CountryChina
- Language:English
-
Abstract:
OBJECTIVE:To evaluate the prevalence and one-year prognosis associated with frailty in a contemporary cohort of older patients with non-ST-elevation acute coronary syndrome (NSTEACS).
METHODS:The IMPACT-TIMING-GO registry (IMPACT of Time of Intervention in patients with Myocardial Infarction with Non-ST seGment elevation. ManaGement and Outcomes) prospectively included 1020 patients with NSTEACS undergoing invasive coronary angiography between April and May 2021. For this sub-study, patients ≥ 65 years were selected. Frailty was assessed according to FRAIL scale. We studied all-cause mortality and the composite of all-cause mortality or all-cause hospitalizations at one-year follow-up after discharge.
RESULTS:Five hundred and sixty seven patients (mean age: 75.8 ± 6.7 years, 28.2% women) were included: 316 (55.7%) were robust, 183 (32.3%) prefrail, and 68 (12.0%) frail. Frail patients were significantly older, more often women, and presented a worse baseline clinical profile. There were no differences among groups regarding pretreatment with a P2Y12 inhibitor. An urgent angiography (< 24 h) was less frequently performed in frail patients, with no differences regarding revascularization approach or in main in-hospital adverse events, although acute kidney disease occurred more frequently in frail patients. At 1-year follow-up, 20 patients died (3.6%). Chronic kidney disease was independently associated with 1-year all-cause death, although a trend towards higher mortality was observed in frail patients (HR = 3.01; 95% CI: 0.93-9.78; P = 0.065). Frailty was independently associated with higher 1-year all-cause mortality or all-cause rehospitalizations (HR = 2.23; 95% CI: 1.43-3.46; P < 0.001).
CONCLUSIONS:In older patients with NSTEACS, frailty independently associates higher all-cause mortality or all-cause hospital admissions at one-year follow-up.
