Clinical Frailty Score Predicts Long-Term Mortality and Hospitalization Due to Heart Failure After Implantation of Cardiac Implantable Electric Device

Matsuda, Yasuhiro; Masuda, Masaharu; Asai, Mitsutoshi; Iida, Osamu; Okamoto, Shin; Ishihara, Takayuki; Nanto, Kiyonori; Kanda, Takashi; Tsujimura, Takuya; Hata, Yutaka; Uematsu, Hiroyuki; Mano, Toshiaki

doi:10.1253/circj.cj-20-0823

Cited by 5 publications

(4 citation statements)

References 30 publications

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“…Of the included studies, 13 studies were considered of having a high risk of bias [ 7 , 31 , 32 , 39 , 41 , 43 , 46 , 52 , 53 , 60 , 61 , 63 , 64 ], 16 as moderate risk of bias [ 18 , 29 , 33 , 36 , 37 , 42 , 44 , 45 , 48 – 50 , 55 , 56 , 58 , 59 , 62 ], and 12 studies had a low risk [ 28 , 30 , 34 , 35 , 38 , 40 , 47 , 51 , 54 , 57 , 65 , 66 ] (Table S2).…”

Section: Resultsmentioning

confidence: 99%

Association between natriuretic peptides and C-reactive protein with frailty in heart failure: a systematic review and meta-analysis

Prokopidis,

Ishiguchi,

Jordan

et al. 2024

Aging Clin Exp Res

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Background Heart failure (HF) and frailty are accompanied by a bidirectional relationship, sharing common risk factors including elevated levels of natriuretic peptides and inflammation. The aim of this study was to compare biomarkers associated with poor clinical outcomes, that is, plasma brain natriuretic peptide (BNP), N-terminal-pro B-type natriuretic peptide (NT-proBNP), and C-reactive protein (CRP) in patients with HF and frailty vs. patients with HF without frailty. Methods From inception until July 2023, PubMed, Scopus, Web of Science, and Cochrane Library a systematic literature search was conducted. To evaluate whether frailty is linked with greater levels of BNP, NT-proBNP, and CRP, a meta-analysis using a random-effects model was used to calculate the pooled effects (CRD42023446607). Results Fifty-three studies were included in this systematic review and meta-analysis. Patients with HF and frailty displayed significantly higher levels of BNP (k = 11; SMD: 0.53, 95%CI 0.30–0.76, I2 = 86%, P < 0.01), NT-proBNP (k = 23; SMD: 0.33, 95%CI 0.25–0.40, I2 = 72%, P < 0.01), and CRP (k = 8; SMD: 0.30, 95%CI 0.12–0.48, I2 = 62%, P < 0.01) vs. patients with HF without frailty. Using meta-regression, body mass index (BMI) and age were deemed potential moderators of these findings. Conclusions Frailty in HF is linked to increased concentrations of BNP, NT-proBNP, and CRP, which have been epidemiologically associated with adverse outcomes. The increased risk of NYHA III/IV classification further emphasizes the clinical impact of frailty in this population.

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Section: Resultsmentioning

confidence: 99%

Association between natriuretic peptides and C-reactive protein with frailty in heart failure: a systematic review and meta-analysis

Prokopidis,

Ishiguchi,

Jordan

et al. 2024

Aging Clin Exp Res

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“…Several studies indicated similar results in which the severity of pre-operative frailty was associated with poor clinical outcomes in patients with other cardiovascular diseases. These include critical limb ischemia patients who underwent bypass surgery [ 33 ]; heart failure patients who experienced implantation of cardiac implantable electric devices [ 34 ]; atrial fibrillation patients who undertook catheter ablation [ 35 ]; and CAD patients who underwent CABG [ 36 ]. However, there is limited data on the clinical outcomes of older frail patients with stable CAD who underwent elective PCI.…”

Section: Discussionmentioning

confidence: 99%

Association of preoperative clinical frailty and clinical outcomes in elderly patients with stable coronary artery disease after percutaneous coronary intervention

et al. 2023

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There are few reports on the long-term clinical outcome after percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD) complicated with frailty. This novel study investigated the association between pre-PCI frailty and long-term clinical outcomes in elderly patients aged 65 years or older with stable CAD who underwent elective PCI. We assessed 239 consecutive patients aged 65 years or older with stable CAD who underwent successful elective PCI at Kagoshima City Hospital between January 1st, 2017 and December 31st, 2020. Frailty was retrospectively assessed using the Canadian Study and Aging Clinical Frailty Scale (CFS). Based on the pre-PCI CFS, patients were divided into two groups: the non-frail (CFS < 5) and the frail (CFS ≥ 5) group. We investigated the association between pre-PCI CFS and major adverse cardiovascular events (MACEs) defined as the composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, and heart failure requiring hospitalization. Additionally, we assessed the association between pre-PCI CFS and major bleeding events defined as Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding. The mean age was 74.8 ± 7.0 years, and 73.6% were men. According to the pre-PCI frailty assessment, 38 (15.9%) and 201 (84.1%) were classified as frail and non-frail groups, respectively. During a median follow-up of 962 (607–1284) days, 46 patients developed MACEs and 10 patients developed major bleeding events. Kaplan–Meier curves showed a significantly higher incidence of MACE in the frail group compared to those in the non-frail group (Log-rank p < 0.001). Even in multivariate analysis, pre-PCI frailty (CFS ≥ 5) was independently associated with MACE (HR 4.27, 95% CI 1.86–9.80, p-value: < 0.001). Additionally, the cumulative incidence of major bleeding events was significantly higher in the frail group than in the non-frail group (Log-rank p = 0.001). Pre-PCI frailty was an independent risk factor for MACE and bleeding events in elderly patients with stable CAD who underwent elective PCI.

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“…Even in the absence of clear etiologies in primary care, clinicians should also consider identifying the potential malignant phenotype that might affect patient prognosis. Based on the previously mentioned AVB severity and LV change, AVB patients with unknown etiologies were divided into four types with distinctive characteristics, of which 17% showed risk features such as advanced AVB, increased LVEDD, and high NT-proBNP levels [ 35 , 36 ] and were classified as the severe phenotype. Among AVB patients with undetermined etiologies who received pacemakers, those who presented with severe phenotype were associated with a triple risk of developing HF symptoms and signs.…”

Section: Discussionmentioning

confidence: 99%

Etiology Distribution, Clinical Characteristics, and Suboptimal Pacing Outcome of Atrioventricular Block in Young Patients

Chen,

Jin,

et al. 2023

Rev. Cardiovasc. Med.

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Background:The causes of atrioventricular block (AVB) are different and diverse young patients, as compared to the old. However, little is known about the etiology distribution and clinical characteristics of AVB in the young group. Methods: We retrospectively analyzed clinical information for AVB patients under 50 years of age. We summarized clinical phenotypes for patients with undetermined AVB etiology, according to AVB type and cardiac-structural change, whereas those who received pacing therapy were followed up for suspected heart failure events (HFEs). Results: AVB etiology was identified in only 289 (61.4%) patients, while 38.6% still have undertermined etiology for AVB. Non-ischemic cardiomyopathy (16.6%) and complication of cardiac surgery (13.4%) were the top two etiologies. In addition, four distinct phenotypes were identified in AVB patients with undetermined etiology, of which the severe phenotype (both borderline/elevated left ventricular diameter or abnormal left ventricular ejection fraction and advanced AVB) accounted for 17%. Notably, 80.7% of patients with severe phenotype received pacing therapy. Based on a median follow-up time of 17.5 months, we found the occurrence of 16 suspected HFEs in 110 pacemaker receivers (12 were lost to follow up). Notably, the severe phenotype was associated with a higher risk of heart failure (HF) symptoms. Conclusions: AVB etiology in young patients under 50 years of age is complex and underdiagnosed. In patients with undetermined etiology, severe phenotype featuring advanced AVB and abnormal Left ventricle (LV) structure/function is associated with a higher rate of HF symptoms even after pacing therapy.

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Clinical Frailty Score Predicts Long-Term Mortality and Hospitalization Due to Heart Failure After Implantation of Cardiac Implantable Electric Device

Cited by 5 publications

References 30 publications

Association between natriuretic peptides and C-reactive protein with frailty in heart failure: a systematic review and meta-analysis

Association between natriuretic peptides and C-reactive protein with frailty in heart failure: a systematic review and meta-analysis

Association of preoperative clinical frailty and clinical outcomes in elderly patients with stable coronary artery disease after percutaneous coronary intervention

Etiology Distribution, Clinical Characteristics, and Suboptimal Pacing Outcome of Atrioventricular Block in Young Patients

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