One-year clinical events according to frailty in older patients with non-ST elevation acute coronary syndrome undergoing coronary angiography:an analysis of the IM PACT-TIMING-GO study
Pablo Díez-Villanueva
Pedro Cepas-Guillén
María Thiscal López Lluva
Alfonso Jurado-Román
Pablo Bazal-Chacón
Martín Negreira-Caamaño
Iván Olavarri-Miguel
Ane Elorriaga
Ricardo Rivera-López
David Escribano
Pablo Salinas
María Martínez-Avial
Antonio Martínez-Guisado
Clea González-Maniega
Felipe Díez-Delhoyo
Abstract：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.
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Publication Date：2025-01-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：10( 159-168 )