Risk factors of frailty in elderly patients with unstable angina pectoris and its effect on prognosis

Chen Ying; Wang Tongcai

doi:10.3760/j.issn.1673-4777.2025.07.003

Abstract：Objective To investigate the risk factors of frailty in elderly patients with unstable angina pectoris(UA)and its effect on prognosis.Methods A total of 255 elderly patients with UA admitted to Inner Mongolia Autonomous Region People's Hospital from January 2021 to December 2023 were selected.According to the presence or absence of frailty,the patients were divided into frailty group and non-frailty group,and the incidence of major adverse cardiovascular events(MACE)was recorded during 1-year follow-up.The clinical data of elderly UA patients were collected,and the risk factors for frailty in elderly UA patients were analyzed by multivariate Logistic regression method and a nomogram model was constructed.The Hosmer-Lemeshow test was used to evaluate the goodness of fit of the model.Receiver operating characteristic(ROC)curve was used to calculate the area under the curve to evaluate the predictive ability of the model.C-index was used to evaluate the discrimination ability of the model.The calibration curve was used to evaluate the consistency of the model.The decision curve was used to evaluate the net benefit of the model.The Kaplan-Meier survival curve was used to compare the incidence of MACE between the frailty group and the non-frailty group.Results The incidence of frailty in 255 elderly patients with UA was 45.1％(115/255).Age,Canadian Cardiovascular Society(CCS)grade Ⅲ-Ⅳ,comorbidity,polypharmacy,sleep disorders,decreased activities of daily living,nutritional risk and cardiac troponin T(cTnT)were independent risk factors for frailty in elderly patients with UA(all P＜0.05).A nomogram model was constructed based on the above independent risk factors,and the Hosmer-Lemeshow test showed P＞0.05.ROC curve and model evaluation showed that the area under the curve of the nomogram model for predicting frailty in elderly UA patients was 0.891,and the consistency index was 0.891.The calibration curve and decision curve showed that the prediction probability of the nomogram model fitted the ideal curve,and the net clinical benefit was greater than 0 when the threshold probability was greater than 0.11.The Kaplan-Meier survival curve showed that the incidence of MACE in the frail group was higher than that in the non-frail group(P＜0.05).Conclusion Age,CCS classification,comorbidity,polypharmacy,sleep disorders,reduced activities of daily living,nutritional risk,and cTnT are risk factors for frailty in elderly UA patients,which have a significant adverse impact on the prognosis.The nomogram prediction model based on risk factors has high predictive value,discrimination ability,consistency and clinical applicability for elderly UA patients complicated with frailty.