Frailty and quality of life after invasive management for no
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Older patients presenting with non-ST elevation acute coronary syndrome (NSTEACS) require holistic assessment. We carried out a longitudinal cohort study to investigate health-related quality of life (HRQoL) of older, frail adults with NSTEACS undergoing coronary angiography.

217 consecutive patients aged more than 65 years (mean age 80.9±4.0 years, 60.8% male) with NSTEACS referred for coronary angiography were recruited from two tertiary cardiac centers. Frailty was assessed with the Fried Frailty Index; a score of 0 was characterized as robust, 1–2 prefrail and more than 3 frail. The Short Form Survey 36 (SF-36), an HRQoL tool consisting of eight domains spanning physical and mental health, was performed at baseline and 1?year.

Results
-- 186 patients (85.7%) had invasive revascularisation. At baseline, 52 (23.9%) patients were frail and 121 (55.8%) were prefrail, with most SF-36 domains falling below the norm-population mean.

-- Patients with frailty had lower mean scores in all physical SF-36 domains compared with those without frailty.

-- Robust patients had temporal improvement in two domains (role physical +5.80 and role emotional +6.46) versus patients with frailty and prefrailty, who had a collective improvement in a greater number of physical and psychological domains at 1?year (2 domains vs 11 domains), notably role physical (prefrail +6.53 and frail +10.4).

Conclusively, Frail older adults with NSTEACS have poor HRQoL. One year following invasive management, there are modest improvements in HRQoL, most marked in frail and prefrail patients, who received a proportionally larger benefit than robust patients.

Source: https://heart.bmj.com/content/early/2021/05/13/heartjnl-2021-319064?rss=1
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