Frailty Significantly Associated with a Risk for Mid-term Outcomes in Elderly Chronic Coronary Syndrome Patients: a Prospective Study

Abstract

Introduction: Frailty is a condition of elderly characterized by increased vulnerability to stressful events. Frail patients are more likely to have adverse events. The purposes of this study were to define frailty in patients aged ≥ 70 years with chronic coronary syndrome (CCS) and to evaluate mortality and prognostic significance of frailty in these patients.

Methods: We included 99 patients, ≥ 70 years old (mean age 74±5.3 years), with diagnosis of CCS. They were followed-up for up to 12 months. The frailty score was evaluated according to the Canadian Study of Health and Aging (CSHA). All patients were divided as frail or non-frail. The groups were compared for their characteristics and clinical outcomes.

Results: Fifty patients were classified as frail, and 49 patients as non-frail. The 12-month Major Adverse Cardiac Events (MACE) rate was 69.4% in frail patients and 20% in non-frail patients. Frailty increases the risk for MACE as much as 3.48 times. Two patients died in the non-frail group and 11 patients died in the frail group. Frailty increases the risk for death as much as 6.05 times. When we compared the aforementioned risk factors by multivariate analysis, higher CSHA frailty score was associated with increased MACE and death (relative risk [RR] = 22.94, 95% confidence interval [CI] 3.33-158.19, P=0.001, for MACE; RR = 7.41, 95% CI 1.44-38.03, P=0.016, for death).

Conclusion: Being a frail elderly CCS patient is associated with worse outcomes. Therefore, frailty score should be evaluated for elderly CCS patients as a prognostic marker.

Keywords: Aging; Canada; Confidence Intervals; Death; Frail Elderly; Frailty; Heart; Multivariate Analysis; Prognosis; Risk Factors.

Fig. 1

Kaplan-Meier survival curves for the frailty. Survival probabilities and their 95% confidence ıntervals in the time “12 months” are 0.93 (0.83-1.00) for non-frail patients and 0.77 (0.64-0.90) for frail patients.

Fig. 2

Kaplan-Meier curves of freedom from Major Adverse Cardiac Events (MACE) to one year. MACE probabilities and their 95% confidence ıntervals in the time “12 months” are 0.58 (0.40-0.76) for non-frail patients and 0.07 (0.00-0.15) for frail patients.