Prevalence and Impact of Frailty in Patients ≥70 Years Old with Acute Coronary Syndrome Referred for Coronary Angiography

Introduction: Elderly patients with acute coronary syndrome (ACS) have a higher risk of adverse cardiovascular events and may be frail but are underrepresented in clinical trials. Previous studies have proposed that frailty assessment is a better tool than chronological age, in assessing older patients’ biological age, and may exceed conventional risk scores in predicting the prognosis. Therefore, we wanted to investigate the prevalence and impact on 12-month outcomes of frailty in patients ≥70 years with ACS referred for coronary angiography (CAG). Methods: Patients ≥70 years with ACS referred for CAG underwent frailty scoring with the clinical frailty scale (CFS). Patients were divided into three groups depending on their CFS: robust (1–3), vulnerable (4), and frail (5–9) and followed for 12 months. Results: Of 455 patients, 69 (15%) patients were frail, 79 (17%) were vulnerable, and 307 (68%) were robust. Frail patients were older (frail: 80.9 ± 5.7 years, vulnerable: 78.5 ± 5.5 years, and robust: 76.6 ± 4.9 years, p < 0.001) and less often treated with percutaneous coronary intervention (frail: 56.5%, vulnerable: 53.2%, and robust: 68.6%, p = 0.014). 12-month mortality was higher among frail patients (frail: 24.6%, vulnerable: 21.8%, and robust: 6.2%, p < 0.001). Frailty was associated with a higher mortality after adjustment for age, sex, comorbidities, the Global Registry of Acute Coronary Events (GRACE) score, and revascularisation (HR 2.67, 95% CI 1.30–5.50, p = 0.008). There was no difference between GRACE and CFS in predicting 12-month mortality (p = 0.893). Conclusions: Fifteen percent of patients ≥70 years old with ACS referred for CAG are frail. Frail patients have significantly higher 12-month mortality. GRACE and CFS are similar in predicting 12-month mortality.

Location
Deutsche Nationalbibliothek Frankfurt am Main
Extent
Online-Ressource
Language
Englisch

Bibliographic citation
Prevalence and Impact of Frailty in Patients ≥70 Years Old with Acute Coronary Syndrome Referred for Coronary Angiography ; volume:149 ; number:1 ; year:2024 ; pages:1-13 ; extent:13
Cardiology ; 149, Heft 1 (2024), 1-13 (gesamt 13)

Creator
Ratcovich, Hanna
Joshi, Francis R.
Palm, Pernille
Færch, Jane
Bang, Lia E.
Tilsted, Hans-Henrik
Sadjadieh, Golnaz
Engstrøm, Thomas
Holmvang, Lene

DOI
10.1159/000535116
URN
urn:nbn:de:101:1-2024021423215416655367
Rights
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Last update
15.08.2025, 7:34 AM CEST

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Associated

  • Ratcovich, Hanna
  • Joshi, Francis R.
  • Palm, Pernille
  • Færch, Jane
  • Bang, Lia E.
  • Tilsted, Hans-Henrik
  • Sadjadieh, Golnaz
  • Engstrøm, Thomas
  • Holmvang, Lene

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