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.

Although its use in daily practice is not common, optical coherence tomography (OCT) is a powerful research tool in invasive cardiology. This report describes a hazy angiography image after percutaneous coronary intervention that has been assessed using OCT. Based on the results of the OCT, the patient underwent an elective coronary angioplasty with standard anticoagulation. After implantation of the stent, an intracoronary hazy image was seen on angiography. The use of OCT permitted a correct diagnosis and a successful treatment. This paper provides a discussion of the advantages and disadvantages of OCT, and a comparison with intravascular ultrasound.
Angiography ; Angioplasty ; Cardiac Catheterization ; Cardiology ; Humans ; Percutaneous Coronary Intervention ; Stents ; Thrombosis ; Tomography, Optical Coherence ; Ultrasonography, Interventional