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Frailty and Age as Predictors of Mortality in Acute Myocardial Infarction Complicated by Cardiogenic Shock

M Wasim Ahmadzai1, Joakim Bo Kunkel1, Peter Laursen Graversen1

  • 1Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

JACC. Advances
|September 18, 2025
PubMed

Insights

Frailty and advanced age significantly increase mortality risk in patients with acute myocardial infarction complicated by cardiogenic shock (AMICS). Identifying these factors is crucial for improving patient outcomes in AMICS.

Area of Science:

  • Cardiology
  • Gerontology
  • Critical Care Medicine

Background:

  • Acute myocardial infarction complicated by cardiogenic shock (AMICS) has a high in-hospital mortality rate (~50%).
  • Frailty is a known predictor of adverse outcomes but is understudied in AMICS.

Purpose of the Study:

  • To assess the independent and combined impact of frailty and age on mortality in AMICS patients.
  • To identify high-risk patient subgroups within AMICS.

Main Methods:

  • Retrospective observational study of 1,716 AMICS patients (RETROSHOCK cohort, 2010-2017).
  • Frailty assessed using Hospital Frailty Risk Score (≥5 defined as frail).
  • Patients stratified by age (≥70 vs <70 years) and analyzed in 5 age groups; mortality assessed at 30 days, 1 year, and 10 years.

Main Results:

  • Frailty present in 22% of patients; 30-day mortality was 65% in frail vs 51% in non-frail (P < 0.001).
  • Patients aged ≥80 years had 82% 30-day mortality; adjusted HR for death was 9.18 compared to non-frail patients <50 years.
  • Combined frailty and age (≥70 years) showed 73% 30-day and 82% 10-year mortality; frailty independently predicted mortality (aHR: 1.84).

Conclusions:

  • Frailty and age are significant, independent predictors of mortality in AMICS.
  • These factors can identify high-risk patients requiring targeted interventions.
Abstract

Keywords:
AMIAMICSHospital Frailty Risk Scorecardiogenic shockfrailtymortality

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