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Routine invasive strategy and frailty burden in non-ST-segment elevation acute myocardial infarction
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作者 Albert Ariza-Solé Juan Andrés Bermeo +22 位作者 Francesc Formiga Héctor Bueno gemma miñana Oriol Alegre David Martí Manuel Martínez-Sellés Laura Domínguez-Pérez Pablo Díez-Villanueva JoséA Barrabés Francisco Marín Adolfo Villa Marcelo Sanmartín Cinta Llibre Alessandro Sionís Antoni Carol Sergio García-Blas María JoséMorales Gallardo Jaime Elízaga Iván Gómez-Blázquez Fernando Alfonso Bruno García Del Blanco Julio Núñez Juan Sanchis 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2024年第10期954-961,共8页
Objective To assess the prognostic impact of a routine invasive strategy according to the frailty burden in patients with non-ST-segment elevation myocardial infarction(NSTEMI)from the MOSCA-FRAIL clinical trial.Metho... Objective To assess the prognostic impact of a routine invasive strategy according to the frailty burden in patients with non-ST-segment elevation myocardial infarction(NSTEMI)from the MOSCA-FRAIL clinical trial.Methods The MOSCA-FRAIL trial randomized 167 frail patients,defined by a Clinical Frailty Scale(CFS)≥4,with NSTEMI to an invasive or conservative strategy.The primary endpoint was the number of days alive and out of hospital(DAOH)one year after discharge.For this subanalysis,we compared the impact of an invasive strategy on the outcomes between vulnerable(CFS=4,n=43)and frail(CFS>4,n=124)patients.Results Compared to vulnerable patients,frail patients presented lower values of DAOH(289.8 vs.320.6,P=0.146),more read-missions(1.03 vs.0.58,P=0.046)and higher number of days spent at the hospital during the first year(10.8 vs.3.8,P=0.014).The cau-ses of readmission were mostly non-cardiac(56%).Among vulnerable patients,DAOH were similar regardless of strategy(invasive vs.conservative:325.7 vs.314.7,P=0.684).Among frailest patients,the invasive group tended to have less DAOH(267.7 vs.311.1,P=0.117).Indeed,patients with CFS>4,invasively managed lived 29 days less than their conservative counterparts.In contrast,the-re were no differences in the subgroup with CFS=4.Conclusions Adult patients with frailty and NSTEMI showed different prognosis according to the degree of frailty.A routine in-vasive strategy does not improve outcomes and might be harmful to the frailest patients. 展开更多
关键词 ROUTINE INVASIVE INFARCTION
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