Assessment of frailty and quality of life in octogenarians with symptomatic coronary artery disease : the FRAIL HEART study

Qayyum, Shouaib

Abstract

BACKGROUND:
Symptomatic coronary artery disease (CAD) is an increasing problem for older adults, however little is known about the relationship between frailty and health outcomes.
PURPOSE:
To determine the prevalence of, and relationship between frailty, quality of life (QoL) and major adverse cardiac events (MACE) in older adults with CAD.
METHODS:
A narrative literature review confirmed a knowledge gap. We therefore conducted an exploratory, prospective observational study of in- or out-patients (≥80years) with symptomatic CAD recruited between June 2016 and January 2017. Participants were evaluated for frailty (Fried Frailty Phenotype, Edmonton Frailty scale), quality of life (QoL; SF-12), clinico-demographic characteristics, including treatments received. Data were collected at baseline and 4 months and descriptive statistics applied. Regression techniques were used to explore relationships between variables.
RESULTS:
Consecutive participants (n=150; mean age 83.7±3.2 years; 99 (66%) men; acute coronary syndrome 82 (54.7%)) were treated with: PCI (51; 34%); CABG (15;10%); medical (84; 56%). About one quarter were frail (26% EFS; 28% FFP). Frailty was inversely related to SF-12 (PCS 30.5±7.1 vs 43.5±7.6, p=0.005, MCS 47.4±i12.8 vs 57.1±6.4, p=0.003) and directly related to comorbidity (7.5±2.4 vs 5.9±1.6, p=0.005) at baseline. Follow up at 114 days (50-243) showed overall MACE (24.7%) and poorer survival amongst frail participants (Dead/frail 50.0% versus alive/frail 26.2%, p=0.002).
CONCLUSIONS:
About one quarter of older adults with CAD have frailty. Our data show that frailty is inversely related with QoL and clinical outcomes. This data suggest that frailty is an important therapeutic target in this age group. A larger cohort is needed to confirm these exploratory findings.

Citation

Qayyum, S. Assessment of frailty and quality of life in octogenarians with symptomatic coronary artery disease : the FRAIL HEART study. (Thesis). Hull York Medical School, the University of Hull and the University of York. https://hull-repository.worktribe.com/output/4223376

• Thesis Type: Thesis
• Deposit Date: Sep 7, 2021
• Publicly Available Date: Feb 23, 2023
• Keywords: Medicine
• Public URL: https://hull-repository.worktribe.com/output/4223376
• Additional Information: Hull York Medical School, The University of Hull and the University of York
• Award Date: Feb 1, 2020