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Objectives <p>To investigate the risk factors for major adverse cardiovascular and cerebrovascular events (MACCE) and rehospitalization in older adults with non-ST-elevation acute coronary syndrome (NSTE-ACS) within one year after discharge.</p> Methods <p>This single-center prospective cohort study enrolled 528 patients, who were categorized into robust, pre-frail, and frail groups based on the FRAIL scale. Multivariate logistic regression analysis was used to identify factors influencing frailty or pre-frailty in these patients. Multivariate Cox regression analysis was performed to assess the factors associated with MACCE and rehospitalization in these patients and examine the prognostic differences among subgroups.</p> Results <p>The prevalence of frailty was 11.4%, and pre-frailty was 51.9%. Frailty was found to be an independent risk factor for MACCE (HR = 2.193, <i>95%CI</i> 1.111–4.326, <i>P</i> = 0.024) and rehospitalization (HR = 1.906, <i>95%CI</i> 1.031–3.522, <i>P</i> = 0.040) in older adults with NSTE-ACS. Subgroup analysis revealed that the old-old frailty group had a higher risk of MACCE compared to the old-old non-frailty group (HR = 2.389, <i>95%CI</i> 1.072–5.322, <i>P</i> = 0.033), while no significant difference in MACCE risk was observed between the young-old frailty group and the old-old frailty group. The comorbid frailty group had a higher risk of rehospitalization than the comorbid non-frailty group (HR = 1.884, <i>95%CI</i> 1.113–3.190, <i>P</i> = 0.018), but no significant difference in rehospitalization risk was found between the non-comorbid frailty group and the comorbid frailty group.</p> Conclusions <p>Frailty is an independent risk factor for MACCE and rehospitalization in older adults with NSTE-ACS. Subgroup analysis further suggests that frailty maybe have greater impact on MACCE and rehospitalization in this population.</p>

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The role of frailty in older adults with Non-ST-elevation acute coronary syndrome: a Chinese population-based cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月30日

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  • Jingwen Shi,
  • Wen Tang,
  • Shan Wang,
  • Xiaopei Hou,
  • Yunli Xing,
  • Junpeng Kan,
  • Bing Liu,
  • Hongwei Li,
  • Ying Sun

摘要

Objectives

To investigate the risk factors for major adverse cardiovascular and cerebrovascular events (MACCE) and rehospitalization in older adults with non-ST-elevation acute coronary syndrome (NSTE-ACS) within one year after discharge.

Methods

This single-center prospective cohort study enrolled 528 patients, who were categorized into robust, pre-frail, and frail groups based on the FRAIL scale. Multivariate logistic regression analysis was used to identify factors influencing frailty or pre-frailty in these patients. Multivariate Cox regression analysis was performed to assess the factors associated with MACCE and rehospitalization in these patients and examine the prognostic differences among subgroups.

Results

The prevalence of frailty was 11.4%, and pre-frailty was 51.9%. Frailty was found to be an independent risk factor for MACCE (HR = 2.193, 95%CI 1.111–4.326, P = 0.024) and rehospitalization (HR = 1.906, 95%CI 1.031–3.522, P = 0.040) in older adults with NSTE-ACS. Subgroup analysis revealed that the old-old frailty group had a higher risk of MACCE compared to the old-old non-frailty group (HR = 2.389, 95%CI 1.072–5.322, P = 0.033), while no significant difference in MACCE risk was observed between the young-old frailty group and the old-old frailty group. The comorbid frailty group had a higher risk of rehospitalization than the comorbid non-frailty group (HR = 1.884, 95%CI 1.113–3.190, P = 0.018), but no significant difference in rehospitalization risk was found between the non-comorbid frailty group and the comorbid frailty group.

Conclusions

Frailty is an independent risk factor for MACCE and rehospitalization in older adults with NSTE-ACS. Subgroup analysis further suggests that frailty maybe have greater impact on MACCE and rehospitalization in this population.