TO EXPLORE THE CLINICAL FRAILTY SCALE IN PREDICTING THE LONG TERM PROGNOSIS OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AFTER IN-HOSPITAL CARDIAC REHABILITATION

Abstract

Objective: Patients successfully revascularized after acute myocardial infarction (AMI) underwent in-hospital cardiac rehabilitation (CR) and were assessed for their state by the clinical frailty scale (CFS) to investigate the predictive value of the CFS score on the incidence rate of major cardiovascular events within one year. Design and method: A graded CR scheme was developed in a total of 501 patients with AMI, who were treated in the cardiology center of Shanghai Sixth People’s Hospital from May 2020 to May 2022, and the CFS score was assessed based on the CR condition of the patients before discharge. Patients were then categorized into three groups (norm group, vulnerable group, and frail group) according to their CFS score. The difference in one-year major cardiovascular event (all-cause death and re-hospitalization for heart failure) rates among these groups was compared. Logistic regression analysis was performed to explore risk factors affecting cardiovascular events, and an ROC curve was generated to analyze the risk factors in predicting one-year cardiovascular event rates. Finally, an optimal prediction model was developed. Results: The CFS score in AMI patients was positively correlated with age and peak proBNP and inversely correlated with gender difference (P <= 0.001). There were significant differences in the incidence of all-cause death between the frail group and the norm group (P = 0.002), whereas there was no significant difference between the vulnerable group and the norm group (P > 0.05). There was no significant difference in re-hospitalization for heart failure among the three groups (P = 0.710). The CFS score could sensitively predict the 1-year risk of all-cause death in AMI patients (β = 1.89, OR = 6.61, P = 0.001), and the risk model combined with the CFS score had the best predictive effect (AUC = 0.845, P = 0.000). Conclusions: In-hospital CR along with assessment using the CFS score can effectively identify AMI patients with a high risk of death.