Effect of frailty on the prognosis of older patients with non-ST-segment elevation acute coronary syndrome undergoing intervention

OBJECTIVE: To investigate the effect of frailty on cardiovascular and cerebrovascular events in older patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing coronary intervention. METHODS: Patients aged ≥65 years with NSTE-ACS admitted to Beijing Friendship Hospital from January 2020 to November 2021 were selected as study participants. Enrolled patients underwent frailty assessment within 24 h of hospitalization using the FRAIL scale. The follow-up endpoints were adverse cardiovascular and cerebrovascular events. A Cox proportional hazards model was used to analyze the association between frailty and out-of-hospital adverse cardiovascular and cerebrovascular events. RESULTS: A total of 456 older patients with NSTE-ACS were included, comprising 50 (11.0%) in the frail group, 236 (51.8%) in the prefrail group, and 170 (37.2%) in the robust group. Compared with the robust group, the prefrail and frail groups were older, had higher proportions of women, higher Global Registry of Acute Coronary Events scores, higher proportions of patients with concomitant diabetes mellitus and cerebrovascular disease, higher Charlson Comorbidity Index scores, and lower Short Physical Performance Battery scores; all differences were statistically significant (P<0.05). The frail group had lower Barthel scores than the robust group (P<0.05). Compared with the prefrail group, the frail group had a higher proportion of women and lower Barthel and Short Physical Performance Battery scores; all differences were statistically significant (P<0.05). The mean follow-up duration after discharge was (12.5±1.2) months. After adjustment for multiple confounding factors, Cox proportional hazards model analysis showed that frailty remained an independent risk factor for out-of-hospital adverse cardiovascular and cerebrovascular events in older patients with NSTE-ACS undergoing coronary intervention (P<0.05). CONCLUSIONS: The prevalence of frailty is high among older patients with NSTE-ACS. Frailty is an independent risk factor for out-of-hospital adverse cardiovascular and cerebrovascular events within 1 year after coronary intervention in older patients with NSTE-ACS. Frailty may affect the clinical benefits of coronary intervention in older patients with NSTE-ACS.