The frailty syndrome and mortality among very old patients with symptomatic severe aortic stenosis under different treatments

Rodríguez-Pascual, Carlos, Paredes-Galán, Emilio, Ferrero-Martínez, Ana Isabel, Baz-Alonso, José Antonio, Durán-Muñoz, Darío, González-Babarro, Eva, Sanmartín, Marcelo, Parajes, Teresa, Torres-Torres, Ivett, Piñón-Esteban, Miguel, Calvo-Iglesias, Francisco, Olcoz-Chiva, Maria Teresa and Rodríguez-Artalejo, Fernando (2016) The frailty syndrome and mortality among very old patients with symptomatic severe aortic stenosis under different treatments. International Journal of Cardiology, 224 . pp. 125-131. ISSN 0167-5273

Full content URL: http://dx.doi.org/10.1016/j.ijcard.2016.09.020

Documents
article/pii/S0167527316322136

Request a copy
[img] PDF
article/pii/S0167527316322136 - Whole Document
Restricted to Repository staff only

68kB
Item Type:Article
Item Status:Live Archive

Abstract

BACKGROUND:
The role of frailty as a prognostic factor in non-selected patients with symptomatic severe aortic stenosis (SAS) is still uncertain. This study aims to examine the association between the frailty syndrome and mortality among very old patients with symptomatic SAS, and to assess whether the association varies with the type of SAS treatment.

METHODS AND RESULTS:
Prospective study of 606 patients aged ≥75years with symptomatic SAS, recruited from February 2010 to January 2015, who were followed up through June 2015. At baseline, frailty was defined as having at least three of the following five criteria: muscle weakness, slow gait speed, low physical activity, exhaustion, and unintentional weight loss. Statistical analyses were performed with multivariate Cox regression. At baseline, 49.3% patients were frail. During a mean follow-up of 98weeks, 35.3% of patients died. The hazard ratio (95% confidence interval) of mortality among frail versus non-frail patients was 1.83 (1.33-2.51). The corresponding results were 1.58 (1.09-2.28) among patients under medical treatment, 3.06 (1.25-7.50) in those with transcatheter aortic valve replacement, and 1.97 (0.83-4.67) in those with surgical aortic valve replacement, p for interaction=0.21. When the frailty criteria were considered separately, mortality was also higher among patients with slow gait speed [1.52 (1.05-2.19)] or low physical activity [1.35 (1.00-1.85)].

CONCLUSIONS:
Frailty is associated with increased mortality among patients with symptomatic SAS, and this association does not vary with the type of SAS treatment. Future studies evaluating the benefits of different treatments in SAS patients should account for baseline frailty.

Keywords:Aortic stenosis, Frailty, Mortality, Older adults, NotOAChecked
Subjects:A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Science > School of Pharmacy
ID Code:27705
Deposited On:05 Jul 2017 11:46

Repository Staff Only: item control page