Abstract 11087: Impact of Frailty on Short-Term and Long-Term Outcomes Among St-Elevation Myocardial Infarction Patients Receiving Primary Percutaneous Coronary Intervention

Abstract

Introduction: The impact of frailty on short-term and long-term outcomes in a contemporary STEMI population is unclear. We hypothesized that in STEMI patients undergoing primary percutaneous coronary intervention (pPCI) frailty would be independently associated with adverse in-hospital and 1-year outcomes. Methods: We retrospectively identified 1,579 STEMI patients aged ≥ 65 years who had received pPCI (2007 - 2020). A frailty index (FI) was determined using the health deficit accumulation model (Table 1). Frail patients were defined as those with a FI > 0.25. The primary outcome was 1-year all-cause mortality. The composite adverse outcome comprised in-hospital all-cause mortality, cardiogenic shock, heart failure, re-infarction, major bleeding, or stroke. A multivariable model adjusting for age, sex, heart failure on presentation, infarct territory, prolonged reperfusion time, initial heart rate, and systolic blood pressure was performed. Results: There were 228 (14.4%) frail patients. Compared to non-frail patients, frail patients were older (mean 80.3 vs. 75.3 years, p < 0.001) and had a higher comorbidity burden. After multivariable adjustment, baseline frailty was independently associated with increased 1-year all-cause mortality, in-hospital all-cause mortality, and the composite adverse outcome (Figure 1). Conclusions: In conclusion, among STEMI patients receiving pPCI, frailty was common and was independently associated with increased in-hospital and long-term adverse outcomes. These findings raise the need for early recognition of frailty and implementation of a comprehensive care model towards the management of frail patients.