Prevalence and impact of frailty in elderly patients with chronic and acute coronary syndrome referred for coronary angiography

Abstract Background The population is getting older worldwide, therefore specific knowledge regarding elderly with cardiovascular disease (CVD) is increasingly needed. Frailty has previously been suggested as a valuable marker for outcome prediction in older CVD patients. Whether the importance of frailty is similar in patients with chronic coronary syndrome (CCS) and acute coronary syndrome (ACS) is not well described. Purpose To compare outcome among frail patients ≥70 years old refereed for coronary angiography (CAG) due to CCS and ACS. Methods Patients ≥70 years old, referred for CAG due to CCS or ACS at our department between 2020-2021, were included in the study and followed for one year. Frailty was evaluated with the Clinical Frailty Scale (CFS) by trained nurses as a part of everyday practice at the cardiology ward. Patients were pooled according to their CFS into a frail/vulnerable (CFS ≥4) and a robust group (CFS 1-3). Study endpoints were all-cause mortality and new hospital admissions for bleeding, myocardial infarction (MI), unplanned revascularisation, or stroke. Results During the study period, a total of 678 patients ≥70 years underwent CAG due to CCS (n=223) or ACS (n=455), had their level of frailty evaluated and completed one-year follow-up. The prevalence of frailty/vulnerability was higher among patients with CCS as compared to patients with ACS (CCS: 43.0% vs. ACS: 32.2%, p=0.009). Frail/vulnerable patients with CCS were younger (CCS: 76.6 (4.7) years vs. ACS: 79.6 (5.7) years, p