Sex-differential effect of frailty on long-termmortality in elderly patients after an acute coronary syndrome

Autores de INCLIVA

• 

  Julio Nuñez Villota

  Autor

• Clara Sastre Arbona

  Autor

• Vicente Ruiz Ros

  Autor

• 

  Clara Bonanad Lozano

  Autor

• Gema Miñana Escriva

  Autor

• 

  Juan Sanchis Fores

  Autor

Participantes ajenos a INCLIVA

• Palau, P
• D'Ascoli, G
• Nunez, E

Grupos y Plataformas de I+D+i

• Grupo de investigación en Cardiología Clínica

  

  Leading Researcher

  Juan Sanchis Fores

• Grupo de Investigación Traslacional en Cardiopatía Isquémica

  

  Leading Researcher

  Vicent Bodí Peris

Abstract

Background: The potential sex-differential effect of frailty in patients with acute coronary syndromes (ACS) has not been well-evaluated. We sought to examine the sex-differential association between frailty status on long-term mortality in elderly patients with an ACS. Methods and results: This is a prospective observational single-center study that included 488 elderly patients (>65 years) hospitalized for ACS who survived the index hospitalization. Multivariate Cox regression was used to determine the association among the exposures (interaction of sex with Fried score and sex with Fried >= 3) and all-cause mortality. The mean age of the sample was 78 +/- 7 years; 41% were female and the median Fried score was higher in women [3 (2-3) vs. 2 (1-2) points, p < 0.001]. At a median follow-up of 3.12 years (IQR:1.38-5.13), 182 deaths (37.3%) were registered. The association of Fried >= 3 with mortality varied across sex (p-value for interaction = 0.022). In males, Fried >= 3 was independently associated with all-cause death (HR = 1.89; CI 95%:1.25-2.85, p = 0.003). However, it showed a neutral effect on women (HR = 0.92; CI 95%:0.57-1.49, p = 0.726). Conclusions: In this work, we found that the frailty status assessed by Fried score was independently associated with mortality in elderly males but not in females with ACS. (C) 2019 Elsevier B.V. All rights reserved.

© 2019 Elsevier B.V. All rights reserved.

Keywords

• Frailty; Women; Prognosis; Acute coronary syndromes