Abstract
Elderly patients represent a large proportion of patients admitted for Acute Coronary Syndrome (ACS). Whether frailty, defined as a biological syndrome that reflects a state of decreased physiological reserve and vulnerability to stressors, may impact the clinical outcomes in this population remains unclear. To determine the prevalence of frailty and its impact on all-cause mortality in patients aged ≥ 80 years admitted for ACS. This prospective observational study was conducted among patients aged 80 or older admitted in a tertiary hospital for ACS. Frailty was assessed using the Edmonton Frail Scale (EFS), which provides a score ranging from 0 (not frail) to 17 (very frail). Population was divided into 3 classes: [0–3] EFS-score, [4–6] EFS-score, and [≥ 7] EFS-score. Two hundred and thirty-six patients were included with a mean follow-up duration of 470 days. The mean age was 85.9 years. Seventy-five patients died during follow-up period. Hundred and nineteen subjects (50.4%) had a [0–3] EFS-score, 68 patients (28.8%) had a [4–6] EFS-score and 49 patients (20.8%) had a [≥ 7] EFS-score. All-cause mortality rate was 17.7% in the [0–3] EFS-score group, 35.3% in the [4–6] EFS-score group and 61.2% in the [≥ 7] EFS-score group ( P < 0.001). After multivariate analysis, frailty status remained associated with all-cause mortality: HR was 1.59 (95% CI [0.78–3.26]) within the [4–6] EFS-score group, and HR was 4.03 (95% CI [2.02–8.04]) within the [≥ 7] EFS-score group ( Table 1 , Fig. 1 ). Frailty is a strong and independent prognosis factor of midterm all-cause mortality in elderly patients presenting with ACS.
Published Version
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