PMID- 37614703
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230924
IS  - 1756-1485 (Electronic)
IS  - 1756-1477 (Print)
IS  - 1756-1485 (Linking)
VI  - 18
DP  - 2023
TI  - Angiographic and Procedural Characteristics in Frail Older Patients with Non-ST 
      Elevation Acute Coronary Syndrome.
PG  - e04
LID - 10.15420/icr.2022.20 [doi]
LID - e04
AB  - BACKGROUND: Angiographic and procedural characteristics stratified by frailty 
      status are not known in older patients with non-ST elevation acute coronary 
      syndrome (NSTEACS). We evaluated angiographic and procedural characteristics in 
      older adults with NSTEACS by frailty category, as well as associations of 
      baseline and residual SYNTAX scores with long-term outcomes. METHODS: In this 
      study, 271 NSTEACS patients aged >/=75 years underwent coronary angiography. 
      Frailty was assessed using the Fried criteria. Angiographic analysis was 
      performed using QAngio(R) XA Medis in a core laboratory. Major adverse 
      cardiovascular events (MACE) consisted of all-cause mortality, MI, stroke or 
      transient ischaemic attack, repeat unplanned revascularisation and significant 
      bleeding. RESULTS: Mean (+/-SD) patient age was 80.5 +/- 4.9 years. Compared with 
      robust patients, patients with frailty had more severe culprit lesion 
      calcification (OR 5.40; 95% CI [1.75-16.8]; p=0.03). In addition, patients with 
      frailty had a smaller mean improvement in culprit lesion stenosis after 
      percutaneous coronary intervention (50.6%; 95% CI [45.7-55.6]) than robust 
      patients (58.6%; 95% CI [53.5-63.7]; p=0.042). There was no association between 
      frailty phenotype and completeness of revascularisation (OR 0.83; 95% CI 
      [0.36-1.93]; p=0.67). A high baseline SYNTAX score (>/=33) was associated with 
      adjusted (age and sex) 5-year MACE (HR 1.40; 95% CI [1.08-1.81]; p=0.01), as was 
      a high residual SYNTAX score (>/=8; adjusted HR 1.22; 95% CI [1.00-1.49]; p=0.047). 
      CONCLUSION: Frail adults presenting with NSTEACS have more severe culprit lesion 
      calcification. Frail adults were just as likely as robust patients to receive 
      complete revascularisation. Baseline and residual SYNTAX score were associated 
      with MACE at 5 years.
CI  - Copyright (c) The Author(s), 2023. Published by Radcliffe Group Ltd.
FAU - Beska, Benjamin
AU  - Beska B
AD  - Translational and Clinical Research Institute, Newcastle University Newcastle, 
      UK.
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust Newcastle, UK.
FAU - Ratcovich, Hanna
AU  - Ratcovich H
AD  - Translational and Clinical Research Institute, Newcastle University Newcastle, 
      UK.
AD  - Department of Cardiology, Rigshospitalet, Copenhagen University Hospital 
      Copenhagen, Denmark.
FAU - Bagnall, Alan
AU  - Bagnall A
AD  - Translational and Clinical Research Institute, Newcastle University Newcastle, 
      UK.
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust Newcastle, UK.
FAU - Burrell, Amy
AU  - Burrell A
AD  - Translational and Clinical Research Institute, Newcastle University Newcastle, 
      UK.
FAU - Edwards, Richard
AU  - Edwards R
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust Newcastle, UK.
FAU - Egred, Mohaned
AU  - Egred M
AD  - Translational and Clinical Research Institute, Newcastle University Newcastle, 
      UK.
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust Newcastle, UK.
FAU - Jordan, Rebecca
AU  - Jordan R
AD  - Worcestershire Acute Hospitals NHS Trust Worcester, UK.
FAU - Khan, Amina
AU  - Khan A
AD  - Leeds Teaching Hospitals NHS Trust Leeds, UK.
FAU - Mills, Greg B
AU  - Mills GB
AD  - Translational and Clinical Research Institute, Newcastle University Newcastle, 
      UK.
FAU - Morrison, Emma
AU  - Morrison E
AD  - Translational and Clinical Research Institute, Newcastle University Newcastle, 
      UK.
FAU - Raharjo, Daniell Edward
AU  - Raharjo DE
AD  - Translational and Clinical Research Institute, Newcastle University Newcastle, 
      UK.
FAU - Singh, Fateh
AU  - Singh F
AD  - Sandwell and West Birmingham Hospitals NHS Trust Birmingham, UK.
FAU - Wilkinson, Chris
AU  - Wilkinson C
AD  - Translational and Clinical Research Institute, Newcastle University Newcastle, 
      UK.
AD  - Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle 
      University Newcastle, UK.
FAU - Zaman, Azfar
AU  - Zaman A
AD  - Translational and Clinical Research Institute, Newcastle University Newcastle, 
      UK.
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust Newcastle, UK.
FAU - Kunadian, Vijay
AU  - Kunadian V
AD  - Translational and Clinical Research Institute, Newcastle University Newcastle, 
      UK.
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust Newcastle, UK.
LA  - eng
GR  - CS/15/7/31679/BHF_/British Heart Foundation/United Kingdom
PT  - Journal Article
DEP - 20230217
PL  - England
TA  - Interv Cardiol
JT  - Interventional cardiology (London, England)
JID - 101559687
PMC - PMC10442670
OTO - NOTNLM
OT  - Angiography
OT  - acute coronary syndrome
OT  - frailty
OT  - older adults
COIS- Disclosure: The authors have no conflicts of interest to declare. Informed 
      consent: All patients provided written informed consent. Data availability: The 
      data that support the findings of this study are available from the Chief 
      Investigator at vijay.kunadian@newcastle.ac.uk and the Study Sponsor Newcastle 
      Joint Research Office, The Newcastle upon Tyne Hospitals NHS Foundation Trust 
      (Level 1, Regent Point, Regent Farm Rd, Gosforth, Newcastle upon Tyne NE3 3HD, 
      UK. E: trust.r&d@nuth.nhs.uk). Ethics: This study was performed in line with the 
      principles of the Declaration of Helsinki. Approval was granted by the National 
      Research Ethics Service (12/NE/0160). Trial registration: Clinicaltrials.gov: 
      NCT01933581. Authors' contributions: Conceptualisation: VK; formal analysis: BB, 
      RJ, AK, GBM, EM, DER, FS; funding acquisition: VK; investigation: BB, AB, AB, RE, 
      ME, RJ, AK, GBM, EM, DER, FS, AZ; project administration: VK; supervision: VK; 
      writing - original draft preparation: BB; writing - review and editing: BB, HR, 
      AB, AB, RE, ME, RJ, AK, GBM, EM, DER, FS, CW, AZ, VK; data curation: BB; 
      methodology: BB, CW; resources: VK; visualisation: BB, CW.
EDAT- 2023/08/24 06:42
MHDA- 2023/08/24 06:43
PMCR- 2023/02/17
CRDT- 2023/08/24 04:07
PHST- 2022/06/02 00:00 [received]
PHST- 2022/09/10 00:00 [accepted]
PHST- 2023/08/24 06:43 [medline]
PHST- 2023/08/24 06:42 [pubmed]
PHST- 2023/08/24 04:07 [entrez]
PHST- 2023/02/17 00:00 [pmc-release]
AID - 10.15420/icr.2022.20 [doi]
PST - epublish
SO  - Interv Cardiol. 2023 Feb 17;18:e04. doi: 10.15420/icr.2022.20. eCollection 2023.