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Prognostic value of frailty in elderly patients with acute coronary syndrome: a systematic review and meta-analysis

BACKGROUND: Frailty is common and associated with poorer outcomes in the elderly, but its prognostic value in acute coronary syndromes (ACS) requires clarification. We thus undertook a systematic review and meta-analysis to evaluate the relationship between frailty and poor prognosis in patients wit...

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Autores principales: Dou, Qingyu, Wang, Wen, Wang, Hui, Ma, Yao, Hai, Shan, Lin, Xiufang, Liu, Ying, Zhang, Xinjun, Wu, Jinhui, Dong, Birong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694517/
https://www.ncbi.nlm.nih.gov/pubmed/31416442
http://dx.doi.org/10.1186/s12877-019-1242-8
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author Dou, Qingyu
Wang, Wen
Wang, Hui
Ma, Yao
Hai, Shan
Lin, Xiufang
Liu, Ying
Zhang, Xinjun
Wu, Jinhui
Dong, Birong
author_facet Dou, Qingyu
Wang, Wen
Wang, Hui
Ma, Yao
Hai, Shan
Lin, Xiufang
Liu, Ying
Zhang, Xinjun
Wu, Jinhui
Dong, Birong
author_sort Dou, Qingyu
collection PubMed
description BACKGROUND: Frailty is common and associated with poorer outcomes in the elderly, but its prognostic value in acute coronary syndromes (ACS) requires clarification. We thus undertook a systematic review and meta-analysis to evaluate the relationship between frailty and poor prognosis in patients with ACS. METHODS: We systematically searched PubMed, Embase to find literatures which studied the prognostic value of frailty in elderly patients with ACS. Our main endpoints were the all-cause mortality, cardiovascular disease (CVD), major bleeding and readmissions. We pooled studies using random-effect generic inverse variance method, and conducted three pre-specified subgroup analyses. RESULTS: Of 1216 identified studies, 15 studies were included in our analysis. Compared with the normal group, frailty (HR = 2.65; 95%CI: 1.81–3.89, I(2) = 60.2%) and pre-frailty (HR = 1.41; 95%CI: 1.19–1.66, I(2) = 0%) were characterized by a higher risk of mortality after adjustment. Frailty also was associated with increased risk of any-type CVD, major bleeding and hospital readmissions in elderly patients with ACS. The pooled effect sizes in frail patients were 1.54 (95%CI: 1.32–1.79), 1.51 (95%CI: 1.14–1.99) and 1.51 (95%CI: 1.09–2.10). CONCLUSIONS: Frailty provides quantifiable and significant prognostic value for mortality and adverse events in elderly ACS patients, helping doctors to appraise the comprehensive prognosis risk and to applicate appropriate management strategies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-019-1242-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-66945172019-08-19 Prognostic value of frailty in elderly patients with acute coronary syndrome: a systematic review and meta-analysis Dou, Qingyu Wang, Wen Wang, Hui Ma, Yao Hai, Shan Lin, Xiufang Liu, Ying Zhang, Xinjun Wu, Jinhui Dong, Birong BMC Geriatr Research Article BACKGROUND: Frailty is common and associated with poorer outcomes in the elderly, but its prognostic value in acute coronary syndromes (ACS) requires clarification. We thus undertook a systematic review and meta-analysis to evaluate the relationship between frailty and poor prognosis in patients with ACS. METHODS: We systematically searched PubMed, Embase to find literatures which studied the prognostic value of frailty in elderly patients with ACS. Our main endpoints were the all-cause mortality, cardiovascular disease (CVD), major bleeding and readmissions. We pooled studies using random-effect generic inverse variance method, and conducted three pre-specified subgroup analyses. RESULTS: Of 1216 identified studies, 15 studies were included in our analysis. Compared with the normal group, frailty (HR = 2.65; 95%CI: 1.81–3.89, I(2) = 60.2%) and pre-frailty (HR = 1.41; 95%CI: 1.19–1.66, I(2) = 0%) were characterized by a higher risk of mortality after adjustment. Frailty also was associated with increased risk of any-type CVD, major bleeding and hospital readmissions in elderly patients with ACS. The pooled effect sizes in frail patients were 1.54 (95%CI: 1.32–1.79), 1.51 (95%CI: 1.14–1.99) and 1.51 (95%CI: 1.09–2.10). CONCLUSIONS: Frailty provides quantifiable and significant prognostic value for mortality and adverse events in elderly ACS patients, helping doctors to appraise the comprehensive prognosis risk and to applicate appropriate management strategies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-019-1242-8) contains supplementary material, which is available to authorized users. BioMed Central 2019-08-15 /pmc/articles/PMC6694517/ /pubmed/31416442 http://dx.doi.org/10.1186/s12877-019-1242-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Dou, Qingyu
Wang, Wen
Wang, Hui
Ma, Yao
Hai, Shan
Lin, Xiufang
Liu, Ying
Zhang, Xinjun
Wu, Jinhui
Dong, Birong
Prognostic value of frailty in elderly patients with acute coronary syndrome: a systematic review and meta-analysis
title Prognostic value of frailty in elderly patients with acute coronary syndrome: a systematic review and meta-analysis
title_full Prognostic value of frailty in elderly patients with acute coronary syndrome: a systematic review and meta-analysis
title_fullStr Prognostic value of frailty in elderly patients with acute coronary syndrome: a systematic review and meta-analysis
title_full_unstemmed Prognostic value of frailty in elderly patients with acute coronary syndrome: a systematic review and meta-analysis
title_short Prognostic value of frailty in elderly patients with acute coronary syndrome: a systematic review and meta-analysis
title_sort prognostic value of frailty in elderly patients with acute coronary syndrome: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694517/
https://www.ncbi.nlm.nih.gov/pubmed/31416442
http://dx.doi.org/10.1186/s12877-019-1242-8
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