Geriatric Assessment and In-Hospital Economic Cost of Elderly Patients With Acute Coronary Syndromes

Rodriguez-Queralto, Oriol; Guerrero, Carme; Formiga, Francesç; Calvo, Elena; Lorente, Victòria; Sánchez‐Salado, José Carlos; Llaó, Isaac; Mateus, Gemma; Alegre, Oriol; Arizá-Solé, Albert

doi:10.1016/j.hlc.2021.05.077

Cited by 5 publications

(4 citation statements)

References 30 publications

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“…Wong, Lee, and El-Jack [ 23 ] used the Essential Frailty Toolset (EFT) [ 30 , 31 ], which has been validated in older patients undergoing transcatheter aortic valve implantation and was recently used in a study of older patients who underwent CABG [ 30 ]. Llao et al [ 19 ] used the FRAIL scale [ 32 ], which has been validated against the Fried score [ 33 ], and has been shown to predict mortality risk in older ACS patients [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

Comparing health outcomes between coronary interventions in frail patients aged 75 years or older with acute coronary syndrome: a systematic review

et al. 2022

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Purpose To assess current evidence comparing the impact of available coronary interventions in frail patients aged 75 years or older with different subtypes of acute coronary syndrome (ACS) on health outcomes. Methods Scopus, Embase and PubMed were systematically searched in May 2022 for studies comparing outcomes between coronary interventions in frail older patients with ACS. Studies were excluded if they provided no objective assessment of frailty during the index admission, under-represented patients aged 75 years or older, or included patients with non-ACS coronary disease without presenting results for the ACS subgroup. Following data extraction from the included studies, a qualitative synthesis of results was undertaken. Results Nine studies met all eligibility criteria. All eligible studies were observational. Substantial heterogeneity was observed across study designs regarding ACS subtypes included, frailty assessments used, coronary interventions compared, and outcomes studied. All studies were assessed to be at high risk of bias. Notably, adjustment for confounders was limited or not adequately reported in all studies. The comparative assessment suggested a possible efficacy signal for invasive treatment relative to conservative treatment but possibly at the risk of increased bleeding events. Conclusions There is a paucity of evidence comparing health outcomes between different coronary interventions in frail patients aged 75 years or older with ACS. Available evidence is at high risk of bias. Given the growing importance of ACS in frail patients aged 75 years or older, new studies are needed to inform optimal ACS care for this population. Future studies should rigorously adjust for confounders.

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Section: Resultsmentioning

confidence: 99%

Comparing health outcomes between coronary interventions in frail patients aged 75 years or older with acute coronary syndrome: a systematic review

et al. 2022

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“…According to the literature, the annual hospitalization cost of coronary heart disease management is about C$2.2 billion or more, and the average annual medication costs were C$1593 per patient in Canada; patients with arrhythmia account for 32% of the total population, and the annual economic burden is about $17.3 billion in Brazil; in 2021, there were 194 patients (with an average age of 82.6 years), and the average hospitalization time was 11.3 days, the economic cost related to admission of each patient was €6,892.15 in Europe. 5 – 7 . At present, the effect of conventional western medicine in the treatment of arrhythmia in coronary heart disease is not good, often with fatigue, sinus bradycardia, sudden drop in blood pressure, diarrhoea, and other adverse reactions 8 , 9 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy, safety, and economy of shensongyangxin capsules for the treatment of coronary heart disease arrhythmia: a meta-analysis of randomized controlled trials

Ma,

Li,

et al. 2023

Annals of Medicine &Amp; Surgery

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Background: Shensong Yangxin Capsules (SSYX) is a proprietary Chinese medicine commonly, used in the treatment of arrhythmia. In recent years, a flurry of randomized controlled trials of SSYX was reported in the treatment of Coronary heart disease arrhythmia in China. However, these experiments have not been systematically evaluated by economics. The purpose of this study was to assess the efficacy, safety, and economy of the SSYX in the treatment of arrhythmia in patients with coronary heart disease. Methods: With “Shensong Yangxin Capsules” “Coronary Heart Disease” “Coronary Atherosclerotic Heart Disease”and “Arrhythmia” as the subject words, the relevant journals and conference papers were searched manually in China National Knowledge Infrastructure (CNKI), Wanfang Database , VIP, PubMed, Web Of Science, CBM, Embase and The Cochrane Library. The literature of randomized controlled trials of SSYX in the treatment of coronary heart disease arrhythmia was searched until November 2022. All data were analyzed using RevMan 5.3 Sotware and combined with cost-effectiveness for economic evaluation. Results: Twenty randomized controlled trials were included in this study, with a total of 2011 cases. The meta-analysis showed that the therapeutic effect of SSYX-metoprolol is superior to that of metoprolol alone. SSYX is superior to amiodarone in improving the total clinical effective rate, reducing the incidence of adverse reactions, and reducing the junction premature beats. There was no significant difference between the SSYX and amiodarone in the curative effect of ECG, ventricular premature complexes, and atrial premature beats. The results of pharmacoeconomics show that SSYX has a cost-effectiveness advantage in treating coronary heart disease arrhythmia. Single-factor sensitivity analysis also confirmed the stability of the results. In summary, SSYX has a curative effect, safety, and economy in treating coronary heart disease arrhythmia.

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“…Frail older adults with ACS are significantly less likely to receive optimal care, for example, percutaneous coronary intervention. In these individuals, frailty is independently associated with different undesirable outcomes, including longer length of hospital, a major component of admission-related costs (Anand et al, 2020; Batty et al, 2019; Bebb et al, 2018; Dou et al, 2019; Kundi et al, 2019; Kwok et al, 2019; Man et al, 2019; Patel et al, 2018; Rodríguez-Queraltó et al, 2021; Uchmanowicz et al, 2019; White et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

“…The prognosis of frail patients with ACS is worse than that of robust patients (Richter et al, 2022). In these patients, higher levels of frailty are related to decreased quality of life (physical, psychological, social, and global aspects; Lisiak et al, 2016), major bleeding, higher stroke rates, longer hospitalization, higher readmission rates, higher rates of in-hospital mortality or non-fatal myocardial (re)infarction within 6 or 30 months of admission, and death (Anand et al, 2020; Batty et al, 2019; Bebb et al, 2018; Dou et al, 2019; Kundi et al, 2019; Kwok et al, 2019; Man et al, 2019; Patel et al, 2018; Rodríguez-Queraltó et al, 2021; Uchmanowicz et al, 2019; White et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Frailty, Sociodemographic and Clinical Characteristics, and Disease Severity of Older Adults With Acute Coronary Syndrome

et al. 2022

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This study aimed to evaluate the relationship between frailty, sociodemographic and clinical characteristics, and disease severity of older adults with acute coronary syndrome (ACS). A total of 57 hospitalized patients ≥60 years with ACS were assessed for frailty through the Tilburg Frailty Indicator. Disease severity was assessed by the Global Registry of Acute Coronary Events, by the maximum troponin level, and by the number of severely obstructed coronary arteries. The relationship between variables was assessed by Mann Whitney’s test, Pearson’s chi-square test, likelihood-ratio test, Fisher’s exact test, or Student’s t test. Analyses were bootstrapped to 1,000 to reduce potential sample bias. About 54.4% were frail. Frailty was associated with ethnicity ( p = .02), marital status ( p = .05), ischemic equivalents ( p = .01), self-perceived health ( p = .002), arthritis/rheumatism/arthrosis ( p = .002), and number of severely obstructed coronary arteries ( p = .05). These relationships can support intensified surveillance planning for the elderly at greatest risk, structuring of transitional care, appropriate nurse-coordinated secondary prevention delivery in primary care, and cardiac rehabilitation following ACS.

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Geriatric Assessment and In-Hospital Economic Cost of Elderly Patients With Acute Coronary Syndromes

Cited by 5 publications

References 30 publications

Comparing health outcomes between coronary interventions in frail patients aged 75 years or older with acute coronary syndrome: a systematic review

Comparing health outcomes between coronary interventions in frail patients aged 75 years or older with acute coronary syndrome: a systematic review

Efficacy, safety, and economy of shensongyangxin capsules for the treatment of coronary heart disease arrhythmia: a meta-analysis of randomized controlled trials

Relationship Between Frailty, Sociodemographic and Clinical Characteristics, and Disease Severity of Older Adults With Acute Coronary Syndrome

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