Combined assessment of frailty and nutritional status can be a prognostic indicator after percutaneous coronary intervention

• Published in: Heart and vessels Vol. 38; no. 3; pp. 332 - 339
• Main Authors: Noike, Ryota, Amano, Hideo, Hirano, Shojiro, Tsubono, Masakazu, Kojima, Yoshimasa, Oka, Yosuke, Aikawa, Hiroto, Matsumoto, Shingo, Yabe, Takayuki, Ikeda, Takanori
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.03.2023; Springer Nature B.V
• Subjects: Aged; Angina; Angina pectoris; Angioplasty; Biomedical Engineering and Bioengineering; C-reactive protein; Cardiac Surgery; Cardiology; Cerebral infarction; Congestive heart failure; Frailty; Frailty - complications; Frailty - diagnosis; Frailty - epidemiology; Geriatric Assessment; Heart failure; Heart Failure - complications; Humans; Kidney diseases; Malnutrition; Malnutrition - complications; Malnutrition - diagnosis; Malnutrition - epidemiology; Medicine; Medicine & Public Health; Myocardial infarction; Nutrition Assessment; Nutritional Status; Original Article; Percutaneous Coronary Intervention - adverse effects; Prognosis; Risk; Risk Factors; Risk groups; Vascular Surgery; Stable angina pectoris; Clinical frailty scale; Percutaneous coronary intervention; Geriatric nutritional risk index
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-022-02176-y

The cardiac prognosis of patients with frailty and malnutrition remains poorly investigated. This study aimed to investigate the impact of frailty and malnutrition on cardiac prognosis by combining the clinical frailty scale (CFS) and the geriatric nutritional risk index (GNRI) in patients who underwent percutaneous coronary intervention (PCI). In this study, 608 patients who underwent PCI for stable angina pectoris between January 2018 and December 2020 were included. CFS scores of ≥ 4 were defined as high CFS and patients with these scores were considered frail. GNRI scores of ≤ 98.0 were defined as low GNRI and patients with these scores were considered to have malnutrition. Patients were categorized into low-risk ( n  = 267, low CFS and high GNRI), intermediate-risk ( n  = 200, high CFS or low GNRI), and high-risk ( n  = 141, high CFS and low GNRI) groups. Major adverse clinical events (MACEs), including all-cause death, nonfatal myocardial infarction, revascularization, hospitalization for heart failure, and stroke, were assessed. The median follow-up period was 529 days. During the follow-up, MACEs were found in 135 patients. The high-risk group were older (77.0 ± 9.2 vs 71.4 ± 10.7 vs 65.0 ± 10.1 years, p  < 0.001), had higher prevalence rates of chronic kidney disease [61.7% (87/141) vs 37.5% (75/200) vs 16.9% (45/267); p  < 0.001] and heart failure [47.5% (67/141) vs 22.5% (45/200) vs 12.4% (33/267), p  < 0.001], and had higher C-reactive protein levels (1.64 ± 2.66 vs 1.00 ± 2.02 vs 0.34 ± 0.90 mg/dL; p  < 0.001) than the intermediate-risk and low-risk groups. The high-risk group [hazard ratio (HR), 4.39; 95% confidence interval (CI), 2.87–6.72; p  < 0.001] was an independent predictor of MACEs. In conclusion, patients with both frailty and malnutrition had a higher risk of MACEs after PCI than patients with frailty or malnutrition. Post-PCI patients should be evaluated for combined frailty and malnutrition.