P2518Frailty and acute coronary syndrome in the over-70 population: frailty is more than age

Abstract

Introduction: Age is empirically used as a tacit marker for frailty, but according to Fried criteria - that evaluate slowing gait, unintentional weight loss, low dailyactivity index, self-reported exhaustion and weakness - age is not a frailty determinant. Frailty impact is not fully understood in acute coronary syndrome (ACS) patients. Aim: We aimed to evaluate frailty impact beyond age in ACS patients. Methods: Monocentric retrospective longitudinal trial including 502 patients over 70 years old admitted between 2011 and 2016 with ACS, whose clinical data permitted simplified Fried criteria estimate. All patients with at least 3 criteria (n=126, 25.5%) were classified as frail (Fr). Demographic, clinical and laboratorial data, past medical history and coronary anatomy information when known were included. Mean follow-up time was 28 months. The population was classified according to occurrence of a composite outcome of death, reinfarction, ischemic stroke or major bleeding (DRIM). Univariate analysis was performed to compare the 2 groups. To identify if frailty was a DRIM predictor, the authors used a regression model with all significant data. Results: DRIM occurred in 119 (24.0%) patients. Univariate analysis is presented in the table. After multivariate analysis, frailty (OR=10.31, CI [5.1-17.5], p<0.001) and dyslipidemia (OR=5.81, CI [2.9-8.5], p<0.001) were independent predictors of DRIM (picture). Conclusion: Frailty, as identified by Fried criteria, is prevalent in older ACS pa- tients, presenting itself as an independent predictor of bad prognosis whose impact surpasses age itself.