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Composite Biomarkers for Assessing Frailty Status in Stable Older Adults With Cardiovascular Disease
Akihiro Hirashiki1, Atsuya Shimizu1, Noriyuki Suzuki1
1Department of Cardiology, National Center for Geriatrics and Gerontology Obu Japan.
Insights
Frailty in older cardiovascular disease patients is linked to lower serum iron and higher blood urea nitrogen (BUN) and C-reactive protein (CRP). These biomarkers may help assess frailty in this population.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Biochemistry
Background:
- Frailty is a significant concern in older adults with cardiovascular disease (CVD).
- The association between specific laboratory measurements and frailty status in stable CVD patients is not well-defined.
- Identifying reliable biomarkers for frailty can aid in clinical assessment and management.
Purpose of the Study:
- To investigate the relationship between various laboratory measurements and frailty status in a cohort of stable older patients with cardiovascular disease.
- To identify specific laboratory markers that can predict or indicate frailty in this patient group.
Main Methods:
- A cohort of 138 stable older patients with cardiovascular disease was assessed.
- Frailty was evaluated using the Kihon Checklist (KCL) scale.
- Laboratory measurements including serum iron, blood urea nitrogen (BUN), and C-reactive protein (CRP) were compared between frail (KCL ≥8) and non-frail (KCL <8) groups.
- Multivariate analysis was performed to identify independent predictors of frailty.
Main Results:
- Frail patients exhibited significantly lower serum iron levels compared to non-frail patients (P<0.001).
- Frail patients showed significantly higher levels of blood urea nitrogen (BUN; P=0.013) and C-reactive protein (CRP; P=0.004).
- Serum iron, CRP, and BUN were identified as significant independent predictors of frailty in multivariate analysis.
Conclusions:
- Frailty status in stable older cardiovascular disease patients is significantly associated with serum iron, CRP, and BUN levels.
- A composite biomarker approach incorporating inflammation, iron deficiency, and renal perfusion indicators may be valuable for assessing frailty in this population.
Abstract:
The relationship between frailty status and laboratory measurements in cardiovascular disease (CVD) remains unclear. We investigated which laboratory measurements indicated frailty in stable older CVD patients. One-hundred thirty-eight stable older CVD patients were evaluated by laboratory measurements, with frailty assessed using the Kihon Checklist (KCL). Laboratory measurements were compared between frail and non-frail groups. Across the entire cohort, mean age was 81.7 years, mean left ventricular ejection fraction was 57.8%, and mean plasma B-type natriuretic peptide was 182 pg/mL. KCL scores were used to divide patients into non-frail (n=43; KCL <8) and frail (n=95; KCL ≥8) groups. Serum iron was significantly lower in the frail than non-frail group (mean [±SD] 61.2±30.3 vs. 89.5±26.1 μg/dL, respectively; P<0.001). Blood urea nitrogen (BUN; 27.3±16.5 vs. 19.7±8.2 mg/dL; P=0.013) and C-reactive protein (CRP; 1.05±1.99 vs. 0.15±0.21 mg/dL; P=0.004) were significantly higher in the frail than non-frail group. Multivariate analysis revealed that serum iron, CRP, and BUN were significant independent predictors of frailty (β=-0.069, 0.917, and 0.086, respectively). Frailty status was significantly associated with iron, CRP, and BUN in stable older CVD patients. Composite biomarkers (inflammation, iron deficiency, and renal perfusion) may be useful for assessing frailty in these patients.
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