The association between frailty and incident cardiovascular disease events in community-dwelling healthy older adults

STUDY OBJECTIVE: This study examined the association between frailty and incident cardiovascular disease (CVD) events, major adverse cardiovascular events (MACE), and CVD-related mortality. DESIGN: Longitudinal cohort study. SETTING: The ASPirin in Reducing Events in the Elderly (ASPREE) clinical tr...

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Detalles Bibliográficos
Autores principales: Ekram, A.R.M. Saifuddin, Tonkin, Andrew M., Ryan, Joanne, Beilin, Lawrence, Ernst, Michael E., Espinoza, Sara E., McNeil, John J., Nelson, Mark R., Reid, Christopher M., Newman, Anne B., Woods, Robyn L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168683/
https://www.ncbi.nlm.nih.gov/pubmed/37168270
http://dx.doi.org/10.1016/j.ahjo.2023.100289
Descripción
Sumario:STUDY OBJECTIVE: This study examined the association between frailty and incident cardiovascular disease (CVD) events, major adverse cardiovascular events (MACE), and CVD-related mortality. DESIGN: Longitudinal cohort study. SETTING: The ASPirin in Reducing Events in the Elderly (ASPREE) clinical trial in Australia and the United States. PARTICIPANTS: 19,114 community-dwelling older adults (median age 74.0 years; 56.4 % females). INTERVENTIONS: Pre-frailty and frailty were assessed using a modified Fried phenotype and a deficit accumulation Frailty Index (FI) at baseline. MAIN OUTCOME MEASURES: CVD was defined as a composite of CVD death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization for heart failure; MACE included all except heart failure. Cox proportional hazards regression was used to analyze the association between frailty and CVD outcomes over a median follow-up of 4.7 years. RESULTS: Baseline pre-frail and frail groups had a higher risk of incident CVD events (Hazard Ratio (HR): 1.31; 95 % Confidence Interval (CI): 1.14–1.50 for pre-frail and HR: 1.63; 95 % CI: 1.15–2.32 for frail) and MACE (pre-frail HR: 1.26; 95 % CI: 1.08–1.47 and frail HR: 1.51; 95 % CI: 1.00–2.29) than non-frail participants according to Fried phenotype after adjusting for traditional CVD risk factors. Effect sizes were similar or larger when frailty was assessed with FI; similar results for men and women. CONCLUSION: Frailty increases the likelihood of developing CVD, including MACE, in community-dwelling older men and women without prior CVD events. Screening for frailty using Fried or FI method could help identify community-dwelling older adults without prior CVD events who are more likely to develop CVD, including MACE, and may facilitate targeted preventive measures to reduce their risk.