INFLUENCE OF FRAILTY SYNDROME ON THE COURSE OF NON-ST-SEGMENT ELEVATION ACUTE CORONARY SYNDROME AND OUTCOMES IN ELDERLY AND SENILE PATIENTS

Abstract

Background. The incidence of non-ST-segment-elevation acute coronary syndrome (NSTEACS) is especially high in elderly. In such patients, concomitant diseases are more common and there is a higher risk of complications, which emphasizes the relevance of the study of frailty syndrome and outcomes in NSTEACS. Objective. The aim of the study was to analyze the effect of frailty on the course of nonST-segment elevation acute coronary syndrome and outcomes in elderly and senile patients. Design and methods. 126 patients with non-ST-segment elevation acute coronary syndrome at the age of 61 to 90 were involved into the study. Follow-up was carried out during 1 year; clinical endpoints were mortality and recurrent acute coronary syndrome. All patients were divided into 3 groups according to the frailty index by M. Hoover et al.: the first group — 49 patients with frailty syndrome (38,9%), the second — 47 (37,3%) with pre-frailty and 30 patients (23,8%) without frailty. Results. Geriatric syndromes, cognitive impairment, depression, decreased basic and instrumental activity were more often in patients with frailty. They also had more complications, such as bleeding, arrhythmias and early post-infarction angina. During 1-year followup 5 patients with frailty (10.2%), 5 patients (10.6%) with pre-frailty, and 2 patients (6.6%) without frailty had adverse outcomes. When analyzing the influence of age and frailty on the development of adverse outcomes (death, repeated ACS), a higher contribution of age was revealed. Conclusion. Patients with ACS and frailty have a higher risk of adverse outcomes. Some of the reasons are various geriatric syndromes, changes in emotional and cognitive status and more frequent complications. Age and frailty were crucial for the development of adverse outcomes. However, senile age was of higher importance for the outcomes.