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Longitudinal Changes in Frailty and Major Adverse Cardiovascular Events in Patients With Coronary Heart Disease

Yihong Ding1, Di He1,2,3, Jiabei He4

  • 1Department of Cardiology Sir Run Run Shaw Hospital, Zhejiang University School of Medicine Hangzhou Zhejiang China.

Journal of the American Heart Association
|July 10, 2026
PubMed

Insights

Frailty increases the risk of major adverse cardiovascular events (MACEs) in coronary heart disease (CHD) patients. Monitoring frailty changes over time is crucial for managing MACEs risk in CHD.

Area of Science:

  • Cardiology
  • Geriatrics
  • Public Health

Background:

  • Frailty is a prevalent condition in patients diagnosed with coronary heart disease (CHD).
  • Understanding the impact of frailty on cardiovascular outcomes is critical for patient management.

Purpose of the Study:

  • To investigate the association between baseline frailty and longitudinal changes in frailty status with the risk of major adverse cardiovascular events (MACEs) in patients with CHD.
  • To assess the prognostic value of frailty progression and recovery in the context of cardiovascular disease.

Main Methods:

  • Utilized data from the Atherosclerosis Risk in Communities (ARIC) study.
  • Assessed frailty using a modified Fried frailty phenotype across two surveys.
  • Employed Cox proportional hazards models to analyze the risk of MACEs, defined as a composite of recurrent CHD, heart failure, stroke, or cardiovascular death.

Main Results:

  • Baseline frailty was associated with an increased risk of MACEs: HR 1.24 for prefrail and 1.75 for frail patients.
  • Progression in frailty status (robust to prefrail/frail, or prefrail to frail) significantly elevated MACEs risk.
  • Recovery from prefrailty to robust status was linked to a reduced risk of MACEs (HR 0.62).

Conclusions:

  • Both the initial degree of frailty and subsequent changes in frailty status are significant predictors of MACEs in CHD patients.
  • Regular monitoring and targeted interventions for frailty can improve cardiovascular outcomes and management strategies for individuals with CHD.
Abstract

Keywords:
cohort studycoronary heart diseasefrailtylongitudinal changesmajor adverse cardiovascular events

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