Evolving burden and consequences of frailty in patients with acute myocardial infarction: evidence from a nationwide cohort.
Background Frailty is common in acute myocardial infarction (AMI), but evidence gaps may cause care disparities and worse outcomes. We examined the prevalence of frailty, its impact on care and its long-term effects. Methods We analysed adults hospitalised with AMI in England and Wales (2005–19) usi...
| Publicado en: | Age & Ageing Vol. 55; no. 2; pp. 1 - 11 |
|---|---|
| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Feb2026
|
| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=192513161&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 192513161 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Feb2026 vid: 55 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 192513161 10.1093/ageing/afag033 ppf: 1 ppct: 10 formats: tig: atl: Evolving burden and consequences of frailty in patients with acute myocardial infarction: evidence from a nationwide cohort. aug: au: Antoun, Ibrahim Mohiaddin, Hasan Mccann, Gerry P Lawson, Claire Khan, Habib R Ahmed, Raheel Ng, Andre Murphy, Gavin J Wijeysundera, Harindra Rashid, Muhammad affil: Department of Cardiovascular Sciences, University of Leicester, University Road, Leicester LE1 7HB, England, United Kingdom of Great Britain and Northern Ireland Centre for Prognosis Research, Keele University, Newcastle-under-Lyme, England, United Kingdom of Great Britain and Northern IrelandDepartment of Research, NIHR Leicester Biomedical Research Centre Cardiovascular Diseases, Leicester, England, United Kingdom of Great Britain and Northern Ireland Department of Cardiovascular Sciences, University of Leicester, University Road, Leicester LE1 7HB, England, United Kingdom of Great Britain and Northern IrelandDepartment of Research, NIHR Leicester Biomedical Research Centre Cardiovascular Diseases, Leicester, England, United Kingdom of Great Britain and Northern Ireland College of Life Sceinces, University of Leicester, Leicester, Leicestershire, United Kingdom of Great Britain and Northern Ireland Department of Cardiology, London Health Sciences Centre, London, Canada Department of Cardiology, Imperial College London National Heart and Lung Institute, London, United Kingdom of Great Britain and Northern Ireland Department of Cardiovascular Sciences, University of Leicester, University Road, Leicester LE1 7HB, England, United Kingdom of Great Britain and Northern IrelandDepartment of Research, NIHR Leicester Biomedical Research Centre Cardiovascular Diseases, Leicester, England, United Kingdom of Great Britain and Northern IrelandDepartment of Cardiology, University Hospitals of Leicester NHS Trust, Leicester, England, United Kingdom of Great Britain and Northern Ireland Department of Cardiovascular Sciences, University of Leicester, University Road, Leicester LE1 7HB, England, United Kingdom of Great Britain and Northern IrelandDepartment of Cardiac Surgery, Glenfield Hospital, Leicester, England, United Kingdom of Great Britain and Northern Ireland Cardiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada Department of Cardiovascular Sciences, University of Leicester, University Road, Leicester LE1 7HB, England, United Kingdom of Great Britain and Northern IrelandCentre for Prognosis Research, Keele University, Newcastle-under-Lyme, England, United Kingdom of Great Britain and Northern IrelandDepartment of Cardiology, University Hospitals of Leicester NHS Trust, Leicester, England, United Kingdom of Great Britain and Northern Ireland su: Wales England Medical quality control Health equity Myocardial infarction treatment Cardiovascular disease related mortality Myocardial infarction Acute diseases Frail elderly Major adverse cardiovascular events Patient readmissions Logistic regression analysis Heart failure Descriptive statistics Multivariate analysis Longitudinal method Confidence intervals Survival analysis (Biometry) Data analysis software Hemorrhage Disease complications sug: subj: Medical quality control Health equity Wales England Myocardial infarction treatment Cardiovascular disease related mortality Myocardial infarction Acute diseases Frail elderly Major adverse cardiovascular events Patient readmissions Logistic regression analysis Heart failure Descriptive statistics Multivariate analysis Longitudinal method Confidence intervals Survival analysis (Biometry) Data analysis software Hemorrhage Disease complications keyword: acute acute myocardial infarction copyrightHolder:British Geriatrics Society copyrightYear:2026 frailty https://dx.doi.org/10.1093/ageing/afag033 inLanguage:en mortality myocardial infarction older people publisher:Oxford University Press quality of care sameAs:https://pubmed.ncbi.nlm.nih.gov/41729759/ acute acute myocardial infarction copyrightHolder:British Geriatrics Society copyrightYear:2026 frailty https://dx.doi.org/10.1093/ageing/afag033 inLanguage:en mortality myocardial infarction older people publisher:Oxford University Press quality of care sameAs:https://pubmed.ncbi.nlm.nih.gov/41729759/ ab: Background Frailty is common in acute myocardial infarction (AMI), but evidence gaps may cause care disparities and worse outcomes. We examined the prevalence of frailty, its impact on care and its long-term effects. Methods We analysed adults hospitalised with AMI in England and Wales (2005–19) using linked registries. Frailty was classified by the Secondary Care Administrative Records Frailty (SCARF) index as fit, mild, moderate or severe. The primary outcome was 1-year all-cause mortality; secondary outcomes included cardiovascular death, Major adverse cardiovascular events (MACE), heart failure readmission, reinfarction and bleeding. Results Of 931 133 patients (median age 70 years, 34% female), 13% had severe frailty, 22% moderate frailty, 36% mild frailty and 29% were classified as fit. Compared with fit patients, those with severe frailty were less likely to receive coronary angiography (44.8% vs. 69.3%), dual antiplatelet therapy (75.5% vs. 93.4%) or referral for cardiac rehabilitation (71.8% vs. 89.7%). Frailty demonstrated a graded association with 1-year mortality: aHR:3.01 (95% CI:2.93–3.10) for severe frailty, 2.33 (95% CI:2.27–2.40) for moderate and aHR:1.65 (95% CI:1.61–1.7) for mild frailty. Similar dose–response patterns were seen for cardiovascular death (aHR:2.82, 95% CI:2.70–2.94; 2.03, 95% CI:1.88–2.20; and 1.12, 95% CI:1.08–1.16), MACE (aHR:2.56, 95% CI:2.51–2.60; 1.84, 95% CI:1.80–1.89; and 1.17, 95% CI:1.15–1.19), heart failure readmission (aHR:3.74, 95% CI:3.61–3.88; 2.79, 95% CI:2.69–2.89; and 1.79, 95% CI:1.73–1.85) and major bleeding (aHR:1.85, 95% CI:1.78–1.92; 1.59, 95% CI:1.51–1.67; and 1.27, 95% CI:1.20–1.34). Conclusion In this national cohort, over one-third of AMI patients had moderate or severe frailty, which was associated with reduced use of evidence-based care and worse outcomes. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
|---|