Association of Frailty With Antiplatelet Response Among Elderly Chinese Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

Liu, Yang; Liu, Shaoyan; Wang, Keyu; Liu, Hongbin

doi:10.1177/1076029620915994

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…The previous results show that in the group of frail older people, the levels of P-selectin, fibrinogen, and thromboxane B 2 were higher than in the group of non-frail older people, which is important to consider since frailty can cause the platelets in these people to be more activated with a higher risk of thrombosis, there being a clear relationship between platelet hyper-reactivity and the occurrence of thromboembolic events, and can contribute to cardiovascular comorbidities in old age [ 110 , 111 ]. Frailty is closely related to oxidative stress, which plays an important role in the mechanism of platelet activation; therefore, some researchers point out that significant changes in oxidative stress may be one of the main causes of a high platelet response in frail patients [ 112 , 113 ]. Descriptions of all of the above-mentioned biomarkers are presented in Table 3 .…”

Section: Blood Biomarkers Associated With Frailtymentioning

confidence: 99%

Frailty in Aging and the Search for the Optimal Biomarker: A Review

et al. 2022

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In the context of accelerated aging of the population worldwide, frailty has emerged as one of the main risk factors that can lead to loss of self-sufficiency in older people. This syndrome is defined as a reduced state of physiological reserve and functional capacity. The main diagnostic tools for frailty are based on scales that show deficits compared to their clinical application, such as the Fried frailty phenotype, among others. In this context, it is important to have one or more biomarkers with clinical applicability that can objectively and precisely determine the degree or risk of frailty in older people. The objective of this review was to analyze the biomarkers associated with frailty, classified according to the pathophysiological components of this syndrome (inflammation, coagulation, antioxidants, and liver function, among others). The evidence demonstrates that biomarkers associated with inflammation, oxidative stress, skeletal/cardiac muscle function, and platelet function represent the most promising markers of frailty due to their pathophysiological association with this syndrome. To a lesser extent but with the possibility of greater innovation, biomarkers associated with growth factors, vitamins, amino acids, and miRNAs represent alternatives as markers of this geriatric syndrome. Likewise, the incorporation of artificial intelligence represents an interesting approach to strengthening the diagnosis of frailty by biomarkers.

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Section: Blood Biomarkers Associated With Frailtymentioning

confidence: 99%

Frailty in Aging and the Search for the Optimal Biomarker: A Review

et al. 2022

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“…Moreover, frailty has been associated with endothelial dysfunction ( 35 ) and activated inflammatory response ( 36 ), two key molecular mechanisms underlying the adverse events after PCI, such as in-stent restenosis ( 37 , 38 ). In addition, in a recent study in elderly Chinese CAD patients after PCI, frailty has been related to high on-aspirin platelet response and high on-clopidogrel platelet response among, a validated independent risk factor of thrombotic events after PCI ( 39 ). Further studies are warranted to evaluate the exact mechanisms involved in the association between frailty and poor prognosis after PCI.…”

Section: Discussionmentioning

confidence: 99%

Frailty Predicts Poor Prognosis of Patients After Percutaneous Coronary Intervention: A Meta-Analysis of Cohort Studies

Wang

Zhang

et al. 2021

Front. Med.

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Background: Frailty has been related to a higher risk of cardiovascular events, while the association between frailty and outcomes for patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI) remains unclear. We performed a meta-analysis of cohort studies to evaluate the above association.Methods: Cohort studies aiming to determine the potential independent association between frailty and clinical outcomes after PCI were identified by search of PubMed, Embase, and Web of Science databases from inception to February 22, 2021. A random-effects model that incorporates the possible heterogeneity among the included studies was used to combine the results.Results: Ten cohort studies with 7,449,001 patients were included. Pooled results showed that frailty was independently associated with higher incidence of all-cause mortality [adjusted risk ratio (RR) = 2.94, 95% confidence intervals (CI): 1.90–4.56, I2 = 56%, P < 0.001] and major adverse cardiovascular events [(MACEs), adjusted RR = 2.11, 95% CI: 1.32–3.66, I2 = 0%, P = 0.002]. Sensitivity analyses limited to studies including elderly patients showed consistent results (mortality: RR = 2.27, 95% CI: 1.51–3.41, I2 = 23%, P < 0.001; MACEs: RR = 2.44, 95% CI: 1.44–4.31, I2 = 0%, P = 0.001). Subgroup analyses showed that characteristics of study design, follow-up duration, or type of PCI did not seem to significantly affect the associations (P-values for subgroup analyses all >0.05).Conclusions: Frailty may be an independent risk factor of poor prognosis for patients with CAD after PCI.

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Long-term aspirin adherence following myocardial infarction and risk of cardiovascular events

Kristensen,

Pareek,

Kragholm

et al. 2024

European Heart Journal - Quality of Care and Clinical Outcomes

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Background and aims Aspirin is considered mandatory after myocardial infarction (MI). However, its long-term efficacy has been questioned. This study investigated the effectiveness of long-term aspirin after MI. Methods Patients ≥ 40 years with MI from 2004–2017 who were adherent to aspirin one year after MI were included from Danish nationwide registries. At 2, 4, 6, and 8 years after MI, continued adherence to aspirin was evaluated. Absolute and relative risks of MI, stroke, or death at 2 years from each timepoint were calculated using multivariable logistic regression analysis with average treatment effect modeling standardized for age, sex, and comorbidities. Subgroup analyses were stratified by sex and age > and ≤ 65 years. Results Among 40 114 individuals included, the risk of the composite endpoint was significantly higher for nonadherent patients at all timepoints. The absolute risk was highest at 2–4 years after MI for both adherent (8.34%, 95% confidence interval [CI]: 8.05–8.64%) and nonadherent patients (10.72%, 95% CI: 9.78–11.66%). The relative risk associated with nonadherence decreased from 4 years after index-MI and onwards: 1.41 (95% CI: 1.27–1.55) at 4–6 years and 1.21 (95% CI: 1.06–1.36) at 8–10 years (Ptrend = 0.056). Aspirin nonadherence in women and individuals > 65 years was not associated with increased risk. Pinteraction at each of the timepoints: Age−<0.001, <0.001, 0.002, 0.51; Sex − 0.25, 0.02, 0.02, 0.82. Conclusion Nonadherence to long-term aspirin was associated with increased risk of MI, stroke, or death, but not in women or individuals > 65 years. The risk decreased from 4 years after MI with near statistical significance.

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Association of Frailty With Antiplatelet Response Among Elderly Chinese Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

Cited by 4 publications

References 27 publications

Frailty in Aging and the Search for the Optimal Biomarker: A Review

Frailty in Aging and the Search for the Optimal Biomarker: A Review

Frailty Predicts Poor Prognosis of Patients After Percutaneous Coronary Intervention: A Meta-Analysis of Cohort Studies

Long-term aspirin adherence following myocardial infarction and risk of cardiovascular events

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