Impact of frailty on the short-term outcomes in very elderly patients with acute myocardial infarction

Objective: The very elderly people constitute an increasingly important sector of patients admitted hospital with acute myocardial infarction (AMI). Frailty is a geriatric syndrome and its prevalence increased with age as well as cardiovascular disease, especially AMI. However, the impact of frailty on clinical outcomes in the very elderly patients with AMI is uncertain. To determine the relationship between frailty and major adverse cardiac events (all-cause death, cardiovascular death, myocardial infarction, stroke and major bleeding) in hospital and at 6 months in the very elderly patients with AMI was carried out in this study.
Patients and Methods: An observation study with cohort, prospective and multicenter trial was done from June 2017 to June 2018. Of 275 patients (≥ 80 years old) with AMI treated at Interventional Cardiology Department of Thong Nhat Hospital, Interventional Cardiology department of Medical University Hospital of Ho Chi Minh City, Cardiology Department of Cho Ray Hospital and Cardiology Department of 30/4 Police Hospital in Ho Chi Minh City were enrolled. Frailty was definied according to the Canada Study of Health and Aging Clinical Frailty Scale.
Results: Of 275 patients, 175 (62, 55%) were considered frailty and the rates of severve/very serverve frailty accounted for 67.44%. Frailty was associated with in-hospital mortality and reinfarction MI (18,02% vs 4,85%; p=0,002 and 4,65% vs 0; p=0,022; respectively). The 6-month MACEs did not significantly differ in frail groups and non frail groups. However, patients with severve/very severve frailty were asscociated with 6-month all-cause and cardiovascular mortality when compare to the mild/moderate frailty group (22,41% vs 1,79% p<0,001 and 15,52% vs 1,79%; p=0,007; respectively).
Conclusions: Frailty was associated with in-hospital mortality and reinfarction MI in the very elderly patients with AMI. Patients with severve/very severve frailty were asscociated with 6-month all-cause and cardiovascular mortality when compare to the mild/moderate frailty group. Therefore, an assessment of frailty is very nessessary to predict the short-term MACEs in such situation.