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Diastolic dysfunction, frailty and prognosis in elderly patients with acute coronary syndromes

Rita Pavasini1, Laura Sofia Cardelli1, Anna Piredda1

  • 1UO Cardiologia, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy.

International Journal of Cardiology
|December 3, 2020
PubMed

Insights

Diastolic dysfunction (DD) in older adults with acute coronary syndrome (ACS) is linked to frailty and poor physical performance (PP). This condition independently predicts worse 1-year outcomes, including re-hospitalization.

Area of Science:

  • Cardiology
  • Geriatrics
  • Echocardiography

Background:

  • Older adults hospitalized for acute coronary syndrome (ACS) often experience comorbidities.
  • Diastolic dysfunction (DD) and frailty/physical performance (PP) are common in this population.
  • The interplay between DD, frailty, and clinical outcomes in ACS patients requires further investigation.

Purpose of the Study:

  • To examine the relationship between diastolic dysfunction (DD) and frailty/physical performance (PP) in elderly ACS patients.
  • To determine if DD predicts 1-year adverse outcomes (all-cause death or re-hospitalization) in this cohort.

Main Methods:

  • Included older adults (≥70 years) hospitalized for ACS undergoing coronary angiography.
  • Assessed diastolic dysfunction (DD) using transthoracic echocardiogram (TTE) before discharge.
  • Evaluated frailty and physical performance (PP) using seven standardized scales.

Main Results:

  • Patients with higher-grade DD (2-3) exhibited poorer frailty and PP scores.
  • Diastolic dysfunction (DD) grade 2-3 was an independent predictor of the composite 1-year endpoint (death or re-hospitalization) after multivariate analysis.
  • The association was primarily driven by a significant increase in 1-year re-hospitalization rates.

Conclusions:

  • In older ACS patients, diastolic dysfunction (DD) assessment correlates with frailty and physical performance (PP) metrics.
  • Diastolic dysfunction (DD) is an independent predictor of adverse 1-year outcomes in this patient group.
  • Echocardiographic assessment of DD may aid in risk stratification for elderly ACS patients.

Keywords:
Acute coronary syndromesDiastolic dysfunctionEchocardiographyElderlyFrailtySPPB

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