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Association of frailty with the risk of ischemic and hemorragic events in the elderly patients with acute coronary syndrome

Authors: Soselia N.N.; Bagmanova N.Kh.; Villevalde S.V.; Kobalava Zh.D.;

Association of frailty with the risk of ischemic and hemorragic events in the elderly patients with acute coronary syndrome

Abstract

Цель. Изучить распространенность и клинические ассоциа-ции синдрома старческой астении (CCA) у пациентов стар-ческого возраста и долгожителей с острым коронарнымсиндромом (ОКС).Материал и методы. У 130 пациентов в возрасте ≥75лет, госпитализированных с ОКС (67,7% женщин, среднийвозраст 82,7±4,7 лет), оценивали наличие ССА по скри-нинговому опроснику “Возраст не помеха”, когнитивныефункции (Mini-Mental State Examination), базовую актив-ность в повседневной жизни (индекс Бартел), питание (Mini Nutritional Assessment), моральное состояние (Philadelphia geriatric morale scale) и двигательную активность. Риск сер-дечно-сосудистых и геморрагических осложнений опреде-ляли по шкалам GRACE, TIMI и CRUSADE.Результаты. ССА диагностировали у 66,1% пациентов.Высокий риск смерти по шкале GRACE на госпитальномэтапе имелся у 60% и 60% пациентов с ОКС без подъемасгемента ST и с подъемом сегмента ST, соответственно, втечение последующих 6 мес - у 91% и 100%. У 53,1%пациентов выявили высокий риск по шкале TIMI, у 73,1% -высокий риск кровотечений по шкале CRUSADE. В группепациентов с ССА была выше доля женщин (p140баллов по шкале GRACE характеризовались более выра-женными изменениями психического статуса (р5 баллов по шкале TIMI были выявлены более высокиебаллы по шкале “Возраст не помеха” (p<0,001), болеевыраженные нарушения базовой активности в повсед-невной жизни (p<0,001). Пациенты с высоким рискомкровотечений характеризовались более выраженнымипроявлениями ССА (p<0,001), нарушениями двигательнойактивности (p<0,01), базовой активности в повседневнойжизни (p<0,001).Заключение. ССА наблюдался у 66,1% пациентов стар-ше 75 лет с ОКС и ассоциировался с большей частотой сер-дечно-сосудистых заболеваний, более высоким рискомсмерти и геморрагических осложнений.

Aim. To assess the prevalence and clinical associations of frailty in the elderly patients with acute coronary syndrome (ACS).Material and methods. We evaluated frailty (national val- idated questionnaire), physical disability (Barthel index), func- tional mobility, nutritional status (Mini Nutrition Assessment), cognitive function (Mini Mental State Examination), mortality and hemorrhagic risk (GRACE, TIMI, CRUSADE scales) in 130 patients aged of ≥75 years (82.7±4.7 years, arterial hyperten- sion in 91.5%, previous myocardial infarction in 32.3%, atrial fibrillation in 32.3%, diabetes in 26.9%) admitted withmyocardial infarction (75.4%) or unstable angina (24.6%).КЛИНИЧЕСКАЯ ФАРМАКОЛОГИЯ И ТЕРАПИЯ, 2018, 27 (2) 31ОРИГИНАЛЬНЫЕ СТАТЬИResults. Frailty was diagnosed in 66.1% of patients. According to the GRACE scale, the risk of in-hospital death was high in 60% of patients with non-ST-segment elevation myocardial infaction and 60% of patients with ST-segment elevation myocardial infarction, while the risk of death within6 months was high in 91% and 100% of patients, respective- ly. TIMI score (>5 points) indicated the high risk of death in53% patients, and CRUSADE score (>40 points) indicated the high risk of bleedings in 73.1% of patients. Patients with frailty were more likely to be women (p140 points had more pronounced cognitive dysfunction (p5 points presented with a higher score on a frailty scale (p40 points had a higher frailty score (p<0.001) and more significant impair- ment of functional mobility (p<0.01) and daily physical activi- ty (p<0.001).Conclusion. Frailty occurs in 66.1% of the elderly patients with ACS and is associated with an increased prevalence of cardiovascular diseases, higher risk of mortality and bleeding.

Keywords

старческий возраст и долгожители, geriatric syndromes, frailty, синдром старче-ской астении, острый коронарный синдром, гериатрические синдромы, elderly, acute coronary syndrome

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green