PMID- 33990413
OWN - NLM
STAT- MEDLINE
DCOM- 20220429
LR  - 20220531
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 108
IP  - 3
DP  - 2022 Feb
TI  - Frailty and quality of life after invasive management for non-ST elevation acute 
      coronary syndrome.
PG  - 203-211
LID - 10.1136/heartjnl-2021-319064 [doi]
AB  - OBJECTIVE: Older patients presenting with non-ST elevation acute coronary 
      syndrome (NSTEACS) require holistic assessment. We carried out a longitudinal 
      cohort study to investigate health-related quality of life (HRQoL) of older, 
      frail adults with NSTEACS undergoing coronary angiography. METHODS: 217 
      consecutive patients aged >/=65 years (mean age 80.9+/-4.0 years, 60.8% male) with 
      NSTEACS referred for coronary angiography were recruited from two tertiary 
      cardiac centres between November 2012 and December 2015. Frailty was assessed 
      with the Fried Frailty Index; a score of 0 was characterised as robust, 1-2 
      prefrail and >/=3 frail. The Short Form Survey 36 (SF-36), an HRQoL tool consisting 
      of eight domains spanning physical and mental health, was performed at baseline 
      and 1 year. RESULTS: 186 patients (85.7%) had invasive revascularisation. At 
      baseline, 52 (23.9%) patients were frail and 121 (55.8%) were prefrail, with most 
      SF-36 domains falling below the norm-population mean. Patients with frailty had 
      lower mean scores in all physical SF-36 domains (p</=0.05) compared with those 
      without frailty. Robust patients had temporal improvement in two domains (role 
      physical +5.80 (95% CI 1.31 to 10.3) and role emotional +6.46 (95% CI 1.02 to 
      11.9)) versus patients with frailty and prefrailty, who had a collective 
      improvement in a greater number of physical and psychological domains at 1 year 
      (2 domains vs 11 domains), notably role physical (prefrail +6.53 (95% CI 3.85 to 
      9.20) and frail +10.4 (95% CI 6.7814.1)). CONCLUSIONS: Frail older adults with 
      NSTEACS have poor HRQoL. One year following invasive management, there are modest 
      improvements in HRQoL, most marked in frail and prefrail patients, who received a 
      proportionally larger benefit than robust patients. TRIAL REGISTRATION NUMBER: 
      NCT01933581.
CI  - (c) Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Beska, Benjamin
AU  - Beska B
AD  - Translational and Clinical Research Institute, Newcastle University, Newcastle 
      upon Tyne, UK.
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust, Newcastle upon Tyne, UK.
FAU - Coakley, Daniel
AU  - Coakley D
AD  - Manchester University NHS Foundation Trust, Manchester Royal Infirmary, 
      Manchester, UK.
FAU - MacGowan, Guy
AU  - MacGowan G
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust, Newcastle upon Tyne, UK.
AD  - Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK.
FAU - Adams-Hall, Jennifer
AU  - Adams-Hall J
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust, Newcastle upon Tyne, UK.
FAU - Wilkinson, Chris
AU  - Wilkinson C
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust, Newcastle upon Tyne, UK.
AD  - Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, 
      UK.
FAU - Kunadian, Vijay
AU  - Kunadian V
AUID- ORCID: 0000-0003-2975-6971
AD  - Translational and Clinical Research Institute, Newcastle University, Newcastle 
      upon Tyne, UK vijay.kunadian@newcastle.ac.uk.
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust, Newcastle upon Tyne, UK.
LA  - eng
SI  - ClinicalTrials.gov/NCT01933581
GR  - CS/15/7/31679/BHF_/British Heart Foundation/United Kingdom
GR  - DH_/Department of Health/United Kingdom
PT  - Clinical Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210514
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - *Acute Coronary Syndrome/diagnosis/therapy
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Frail Elderly
MH  - *Frailty/diagnosis
MH  - Geriatric Assessment
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Quality of Life
OTO - NOTNLM
OT  - acute coronary syndrome
OT  - atherosclerosis
OT  - percutaneous coronary intervention
COIS- Competing interests: None declared.
EDAT- 2021/05/16 06:00
MHDA- 2022/04/30 06:00
CRDT- 2021/05/15 05:38
PHST- 2021/01/26 00:00 [received]
PHST- 2021/04/15 00:00 [revised]
PHST- 2021/04/21 00:00 [accepted]
PHST- 2021/05/16 06:00 [pubmed]
PHST- 2022/04/30 06:00 [medline]
PHST- 2021/05/15 05:38 [entrez]
AID - heartjnl-2021-319064 [pii]
AID - 10.1136/heartjnl-2021-319064 [doi]
PST - ppublish
SO  - Heart. 2022 Feb;108(3):203-211. doi: 10.1136/heartjnl-2021-319064. Epub 2021 May 
      14.