Frailty score for elderly patients is associated with short-term clinical outcomes in patients with ST-segment elevated myocardial infarction treated with primary percutaneous coronary intervention
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Updated: Jan 29, 2026
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
M P J Hermans1, D C Eindhoven1, L A M van Winden1
1Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands.
Insights
Frailty, measured by the VMS score, independently predicts short-term mortality and serious adverse events in elderly patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction.
Area of Science:
- Cardiology
- Geriatrics
- Public Health
Background:
- The aging population is increasing the incidence of ST-elevation myocardial infarction (STEMI) in elderly individuals.
- Primary percutaneous coronary intervention (PCI) is the standard reperfusion therapy for STEMI in this demographic.
- Effective risk stratification is crucial for managing elderly STEMI patients.
Purpose of the Study:
- To evaluate the association between frailty and short-term clinical outcomes in elderly patients with STEMI.
- To determine if frailty predicts mortality and PCI-related serious adverse events (SAE) after primary PCI.
Main Methods:
- Retrospective analysis of 206 STEMI patients (≥70 years) treated with primary PCI from 2013-2015.
- Frailty was assessed using the Safety Management Programme (VMS) score.
- Primary endpoint: 30-day all-cause mortality. Secondary endpoints included 30-day SAEs.
Main Results:
- 28% of patients had a VMS score ≥1, indicating frailty.
- A VMS score ≥1 was an independent predictor of 30-day mortality (OR 9.6) and 30-day SAEs (OR 2.9).
- 30-day mortality and SAE rates were 5% and 23%, respectively.
Conclusions:
- Frailty, as indicated by the VMS score, is significantly associated with increased short-term mortality and PCI-related SAEs in elderly STEMI patients.
- Incorporating frailty assessment into risk models is essential for optimizing care in this population.
- These findings highlight the importance of evaluating frailty in elderly STEMI patients undergoing primary PCI.
Objective:
Consistent with the aging population in the Western world, there is a growing number of elderly patients with ST-segment elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI) is the recommended reperfusion strategy in elderly patients; risk models to determine which of these patients are prone to have poor clinical outcomes are, however, essential. The purpose of this study was to assess the association between frailty and short-term mortality and PCI-related serious adverse events (SAE) in elderly patients.
Methods:
All STEMI patients (aged ≥70 years) treated with primary PCI in 2013-2015 at the Leiden University Medical Centre were assessed. The Safety Management Programme (VMS) score was used to identify frail elderly patients. The primary endpoint was 30-day all-cause mortality; the secondary endpoint included 30-day clinical death, target vessel failure, major bleeding, contrast induced kidney insufficiency and stroke.
Results:
A total of 206 patients were included (79 ± 6.4 years, 119 [58%] male). The VMS score was ≥1 in 28% of all cases. Primary and secondary endpoint rates were 5 and 23% respectively. VMS score ≥1 was an independent predictor for both 30-day mortality (odds ratio [OR] 9.6 [95% confidence interval, CI 1.6-56.9] p-value = 0.013) and 30-day SAE (OR 2.9 [95% CI 1.1-7.9] p-value = 0.038).
Conclusions:
VMS score for frailty is independently associated with short-term mortality and PCI-related SAE in elderly patients with STEMI treated with primary PCI. These results suggest that frailty in elderly patients is an important feature to measure and to be taken into account when developing risk models.
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