Course Of Acute Coronary Syndrome In Patients With Frailty

Abstract

Study materials and methods. In recent years, it is relevant to study the relationship of frailty with the outcome of treatment of patients with ischemic heart disease (IHD) and developed acute coronary syndrome (ACS). The goal of this study was to study the course and outcome of acute coronary syndrome with ST-segment elevation and without ST-segment elevation in patients of older age groups with frailty. The research was a retrospective, current and prospective study of the registers of patients with acute coronary syndrome within the framework of the international project “GIRAFFE – Gerontological Research International Against Frailty: Fit Experience”. 1635 patients with IHD were examined (1002 patients of middle age, 633 patients of elderly and senile age). Frailty was diagnosed in 368 patients of elderly and senile age, 265 patients had no frailty. One of four treatment strategies was chosen for patients under study: emergency invasive, early invasive, late (delayed) invasive and conservative. Study results. The evaluation of unfavorable coronary events carried out according to the criteria of MACE (Major Adverse Coronary Events) showed that in patients with ACS with ST-segment elevation, as well as in patients without ST-segment elevation receiving conservative therapy, the risk of adverse cardiac events is higher than in patients undergoing invasive therapy. When joining frailty syndrome, the development of adverse cardiac events increases significantly. The excess of the average intrahospital lethality was observed only in elderly and senile patients with frailty, what proved the necessity of correction of frailty in order to improve the results of treatment of patients with ACS with ST-segment elevation and without ST-segment elevation by leveling the negative impact of frailty on the outcome of treatment of acute coronary syndrome Keywords : acute coronary syndrome , frailty, elderly and senile age