Introduction Elderly patients with acute coronary syndrome (ACS) have a higher risk of adverse cardiovascular events and may be frail but are underrepresented in clinical trials. Previous studies have proposed that frailty assessment is a better tool than chronological age, in assessing older patients' biological age, and may exceed conventional risk scores in predicting prognosis. Therefore, we wanted to investigate prevalence and impact on 12-month outcomes of frailty in patients ≥70 years with ACS referred for coronary angiography (CAG). Methods Patients ≥70 years with ACS referred for CAG underwent frailty scoring with the clinical frailty scale (CFS). Patients were divided into three groups depending on their CFS: Robust (1-3), Vulnerable (4) and Frail (5-9) and followed for 12 months. Results Of 455 patients, 69 (15%) patients were frail, 79 (17%) were vulnerable and 307 (68%) were robust. Frail patients were older (frail: 80.9±5.7 years, vulnerable: 78.5±5.5 years and robust 76.6±4.9 years, p<0.001) and less often treated with percutaneous coronary intervention (frail: 56.5%, vulnerable: 53.2% and robust: 68.6%, p=0.014). 12-month mortality was higher among frail patients (frail: 24.6%, vulnerable: 21.8% and robust: 6.2%, p<0.001). Frailty was associated with a higher mortality after adjustment for age, sex, comorbidities, GRACE score and revascularisation (HR 2.67, 95%CI 1.30-5.50, p=0.008). There was no difference between GRACE and CFS in predicting 12-month mortality (p=0.893). Conclusions 15% of patients ≥70 years with ACS referred for CAG are frail. Frail patients have significantly higher 12-month mortality. GRACE and CFS are similar in predicting 12-month mortality.

中文翻译：

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≥70 岁因急性冠状动脉综合征转诊进行冠状动脉造影的患者虚弱的患病率和影响。

简介 患有急性冠状动脉综合征 (ACS) 的老年患者发生不良心血管事件的风险较高，并且可能身体虚弱，但在临床试验中代表性不足。先前的研究提出，在评估老年患者的生物年龄方面，衰弱评估是比实际年龄更好的工具，并且在预测预后方面可能超过传统的风险评分。因此，我们想要调查 ≥70 岁 ACS 转诊进行冠状动脉造影 (CAG) 的患者衰弱的患病率及其对 12 个月结果的影响。方法 ≥70 岁的 ACS 转诊至 CAG 的患者接受临床衰弱量表 (CFS) 进行衰弱评分。根据患者的 CFS，将患者分为三组：稳健组 (1-3)、脆弱组 (4) 和虚弱组 (5-9)，并随访 12 个月。结果 455 名患者中，69 名（15%）患者体弱，79 名（17%）患者脆弱，307 名（68%）患者身体健壮。虚弱患者年龄较大（虚弱：80.9±5.7岁，脆弱：78.5±5.5岁，健壮：76.6±4.9岁，p<0.001）并且较少接受经皮冠状动脉介入治疗（虚弱：56.5%，脆弱：53.2%，健壮： 68.6%，p=0.014）。体弱患者的 12 个月死亡率较高（体弱：24.6%，脆弱：21.8%，健壮：6.2%，p<0.001）。调整年龄、性别、合并症、GRACE 评分和血运重建后，虚弱与较高的死亡率相关（HR 2.67，95%CI 1.30-5.50，p=0.008）。GRACE 和 CFS 在预测 12 个月死亡率方面没有差异 (p=0.893)。结论 转诊至 CAG 的 ≥70 岁 ACS 患者中有 15% 身体虚弱。体弱患者的 12 个月死亡率显着更高。GRACE 和 CFS 在预测 12 个月死亡率方面相似。