SPC365

Does frailty have an influence on MINOCA?

Session: Sessão de Posters 15 - Patologias diversas em Cardiologia
Speaker: Margarida G. Figueiredo

Congress: CPC 2024
Topic: P. Other
Theme: 37. Miscellanea
Subtheme: 30.14 Cardiovascular Disease in Special Populations - Other
Session Type: Cartazes
FP Number: ---
Authors: Margarida G. Figueiredo; Sofia B. Paula; Mariana Santos; Adriana Silva; Mariana Coelho; Samuel Almeida; Artur Lopes; Lurdes Almeida
<p><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">Frailty is a condition that is associated with aging, the presence of comorbidities and disability. The occurrence of frailty may aggravate the course of illnesses, including myocardial infarction (MI). </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">Purpose: We aim to build and validate for our population a frailty &iacute;ndex (FI) using the information present in the National Registry of Acute Coronary Syndromes, and then characterize our sample and evaluate the impact of frailty in patients with acute MI with non-obstructive coronary arteries (MINOCA), in terms of management, complications, in-hospital mortality and 1-year mortality in a real-world scenario. Methods: </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">Multicenter retrospective study, based on the </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">National Registry of Acute Coronary Syndromes</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">, from 1/10/2010-24/10/2022. Only patients (P) hospitalized with a diagnosis of MINOCA (coronary stenosis &lt;50%) were included. FI was created including</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;"> twenty-two </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">variables</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;"> identified from baseline characteristics (Table 1).</span></span> <span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">Each patient received a frailty score between 0 and 22, and the FI was calculated, ranging between 0-1. </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">P were then divided into two groups: Group A - </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">non-frail (FI </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">&le;</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">0.25) &ndash; and Group B &ndash; frail (FI&gt;0.25). </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">Kaplan-Meier test was performed to establish the survival rates, CV readmissions and readmissions for other causes, at one year.</span></span> <span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">Results: A total of 1358 P were analyzed, 1195 in 88.0% in group A and 12.0% in group B. Mean age was 63.9&plusmn;13.9 years and 62.8% of P were male in group A, while in group B mean age was 68.0&plusmn;10.8 and 72.4% were men. Group B had more cardiovascular risk factors, such as hypertension (94.5% vs 63.2% p&lt;0.001), diabetes (55.2% vs 22.6% p&lt;0.001), dyslipidemia (52.2% vs 89.0% p&lt;0.001). P in group B also had more previous history of valvular heart disease (12.3% vs 1.4% p&lt;0.001), heart failure (27.6% vs 4.9% p&lt;0.001), stroke (15.3% vs 3.9% p&lt;0.001), and chronic kidney disease (17.8% vs 1.5% p&lt;0.001). On admission, group B presented: higher heart rate (HR) -15.7% of P with HR </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">&ge;</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">100bpm vs 9.0% in group A (p=0.008) -, more atrial fibrillation (14.7% vs 6.7%, p&lt;0.001); lower blood pressure (BP) - 5.1% with BP &lt;90mmHg vs 1.0% (p&lt;0.001)-, and higher Killip-Kimball classification (24.1% of P in Killip Kimball class &gt;I vs 8.3%, p&lt;0.001). There were no differences between the two groups in terms of complications during hospitalization, intrahospital mortality or length of hospital stay. No statistically significant differences were seen regarding mortality rates, readmissions for cardiovascular causes and readmissions for other causes at one-year follow-up, with a Kaplan-Meier test of p=0.186 (Figure 1A), p=0.789 (Figure 1B) and p=0.118 (Figure 1C), respectively.</span></span> <span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">Conclusions: As expected, frail P have more comorbidities than non-frail P. However, this does not translate into differences in terms of P treatment, number of complications, intrahospital mortality, lenght of hospital stay or outcomes at 1-year follow-up.</span></span></p>