Usefulness of Clinical Data and Biomarkers for the Identification of Frailty After Acute Coronary Syndromes
| Autor: | Juan Sanchis, Eduardo Núñez, Enrique Rodríguez-Borja, Julio Núñez, Carlos Hermenegildo, Vicente Ruiz, Clara Bonanad, Omar Cauli, Julio Fernández, Sergio García-Blas, Luis Mainar, Francisco J. Chorro, Ernesto Valero |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Acute coronary syndrome Frail Elderly Myocardial Infarction Comorbidity Disease Cohort Studies Risk Factors Internal medicine Vitamin D and neurology Humans Medicine Myocardial infarction Acute Coronary Syndrome Cystatin C Vitamin D Geriatric Assessment Aged Aged 80 and over business.industry Prognosis medicine.disease Patient Discharge Surgery Patient Outcome Assessment Heart failure Hemoglobinometry Biomarker (medicine) Female Cardiology and Cardiovascular Medicine business Biomarkers Follow-Up Studies Cohort study |
| Zdroj: | Canadian Journal of Cardiology. 31:1462-1468 |
| ISSN: | 0828-282X |
| Popis: | Background Frailty predicts mortality after acute coronary syndrome (ACS). The standard frailty scales, such as the Fried score, consist of a variety of questionnaires and physical tests. Our aim was to investigate easily available clinical data and blood markers to predict frailty at discharge, in elderly patients after ACS. Methods A total of 342 patients older than 65 years, survivors after ACS, were included. A high number of clinical variables were collected. In addition, blood markers potentially linked to frailty and related to the processes of inflammation, coagulation, hormonal dysregulation, nutrition, renal dysfunction, and heart dysfunction were determined. Frailty was evaluated using the Fried score at discharge. The main outcome was frailty defined by a Fried score ≥ 3 points. Secondary endpoints were mortality and myocardial infarction at 30-month median follow-up. Results A total of 116 patients were frail. Seven clinical variables or biomarkers predicted frailty: age ≥ 75 years, female, prior ischemic heart disease, admission heart failure, haemoglobin ≤ 12.5 g/dL, vitamin D ≤ 9 ng/mL, and cystatin-C ≥ 1.2 mg/L. This model based on clinical data and biomarkers showed an excellent discrimination accuracy for frailty (C-statistic = 0.818). During the follow-up, 105 patients died and 137 died or suffered myocardial infarction. The clinical data and biomarker model (C-statistics = 0.730 and 0.691) performed better than the Fried score (C-statistics = 0.676 and 0.650) for death and death or myocardial infarction, respectively. Conclusions Easy available clinical data and biomarkers can identify frail patients at discharge after ACS and predict outcomes better than the standard Fried's frailty scale. |
| Databáze: | OpenAIRE |
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