1. Frailty assessment and risk prediction by GRACE score in older patients with acute myocardial infarction
- Author
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Atul Anand, Sarah Cudmore, Shirley Robertson, Jacqueline Stephen, Kristin Haga, Christopher J. Weir, Scott A. Murray, Kirsty Boyd, Julian Gunn, Javaid Iqbal, Alasdair MacLullich, Susan D. Shenkin, Keith A. A. Fox, Nicholas Mills, and Martin A. Denvir
- Subjects
Frailty ,Risk prediction ,Myocardial infarction ,Acute coronary syndrome ,Geriatrics ,RC952-954.6 - Abstract
Abstract Background Risk prediction after myocardial infarction is often complex in older patients. The Global Registry of Acute Coronary Events (GRACE) model includes clinical parameters and age, but not frailty. We hypothesised that frailty would enhance the prognostic properties of GRACE. Methods We performed a prospective observational cohort study in two independent cardiology units: the Royal Infirmary of Edinburgh, UK (primary cohort) and the South Yorkshire Cardiothoracic Centre, Sheffield, UK (external validation). The study sample included 198 patients ≥65 years old hospitalised with type 1 myocardial infarction (primary cohort) and 96 patients ≥65 years old undergoing cardiac catheterisation for myocardial infarction (external validation). Frailty was assessed using the Clinical Frailty Scale (CFS). The GRACE 2.0 estimated risk of 12-month mortality, Charlson comorbidity index and Karnofsky disability scale were also determined for each patient. Results Forty (20%) patients were frail (CFS ≥5). These individuals had greater comorbidity, functional impairment and a higher risk of death at 12 months (49% vs. 9% in non-frail patients, p
- Published
- 2020
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