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de Souza Ramos JTG, Ferrari FS, Andrade MF, de Melo CS, Boas PJFV, Costa NA, Pereira AG, Dorna MS, Azevedo PS, Banerjee J, Phillips BE, Atherton PJ, Polegato BF, Okoshi K, Zanati SG, Paiva SAR, Zornoff LAM, Minicucci MF. Association between frailty and C-terminal agrin fragment with 3-month mortality following ST-elevation myocardial infarction. Exp Gerontol 2021; 158:111658. [PMID: 34920013 DOI: 10.1016/j.exger.2021.111658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/04/2022]
Abstract
The objective of this study was to evaluate the association between frailty, evaluated by the Clinical Frailty Scale (CFS) and FRAIL scale, and C-terminal agrin fragment (CAF) levels with 3-month mortality following ST-segment elevation myocardial infarction (STEMI). This was a prospective observational study that included patients over the age of 18 years with STEMI admitted to the coronary intensive care unit. Within 48 h of admission, the CFS and FRAIL scale were applied and blood samples collected for serum CAF evaluation. Patients were followed for 3 months after hospital discharge, and mortality was recorded. One hundred and eleven patients were included; mean age was 62.3 ± 12.4 years, 61.3% were male and 11.7% died during the 3 months of follow-up. According to the CFS, 79.3% of the patients were classified as not frail, 12.6% as pre-frail and 8.1% as frail. According to the FRAIL scale, 31.5% of the patients were classified as not frail, 53.2% as pre-frail and 15.3% as frail. In univariate analysis, the CFS but not FRAIL scale was associated with mortality. In multiple logistic regression analysis, pre-frail/frail according to CFS (odds ratio [OR]: 6.118; CI 95%: 1.344-27.848; p = 0.019) and CAF levels (OR: 0.943; CI 95%: 0.896-0.992; p = 0.024) were associated with increased 3-month mortality. In a sub-analysis of 53 patients ≥65 years, CFS and CAF levels were associated with 3-month mortality. In conclusion, CAF levels and frailty determined by the CFS were associated with 3-month mortality after STEMI in the general and older population.
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Affiliation(s)
- Juan Thomaz Gabriel de Souza Ramos
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Felipe Sanches Ferrari
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil
| | - Morganna Freitas Andrade
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Caroline Souto de Melo
- Department of Anesthesiology, Complexo Hospitalar Santa Genoveva de Uberlândia, Minas Gerais, Brazil
| | - Paulo José Fortes Villas Boas
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Nara Aline Costa
- Faculty of Nutrition, UFG- Univ Federal de Goiás, Goiânia, Brazil
| | - Amanda Gomes Pereira
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil
| | - Mariana Souza Dorna
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil
| | - Paula Schmidt Azevedo
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Jay Banerjee
- Geriatric Emergency Medicine, University Hospitals of Leicester, School of Health Science, University of Leicester, Leicester, UK
| | - Bethan E Phillips
- Medical Research Council-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Derby, UK
| | - Philip J Atherton
- Medical Research Council-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Derby, UK
| | - Bertha Furlan Polegato
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Katashi Okoshi
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Silmeia Garcia Zanati
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Sergio Alberto Rupp Paiva
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Leonardo Antonio Mamede Zornoff
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Marcos Ferreira Minicucci
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil.
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