Physical Frailty May Predict 2-Year Prognosis in Elderly Patients With Acute Myocardial Infarction　― A Report From the FLAGSHIP Study ―

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  • Ashikawa Hironobu
    Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine
  • Adachi Takuji
    Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine
  • Iwatsu Kotaro
    Department of Rehabilitation, Hirakata Kohsai Hospital
  • Kamisaka Kenta
    Department of Rehabilitation, Tazuke Kofukai Medical Institute Kitano Hospital
  • Kamiya Kuniyasu
    Department of Hygiene & Public Health, Osaka Medical and Pharmaceutical University
  • Uchiyama Yasushi
    Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine
  • Yamada Sumio
    Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine Department of Cardiology, Aichi Medical University

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<p>Background: Elderly patients with acute myocardial infarction (AMI) are a high-risk population for heart failure (HF), but the association between physical frailty and worsening prognosis, including HF development, has not been documented extensively.</p><p>Methods and Results: As part of the FLAGSHIP study, we enrolled 524 patients aged ≥70 years hospitalized for AMI and capable of walking at discharge. Physical frailty was assessed using the FLAGSHIP frailty score. The primary outcome was a composite outcome of all-cause death and HF rehospitalization within 2 years after discharge. The secondary outcome was all-cause death and HF rehospitalization. After adjusting for confounders, physical frailty showed a significant association with an increased risk of the composite outcome (hazard ratio [HR]=2.09, 95% confidence interval [CI]: 1.03–4.22, P=0.040). The risk of HF rehospitalization increased with physical frailty, but the association was not statistically significant (HR=2.14, 95% CI: 0.84–5.44, P=0.110). Physical frailty was not associated with an increased risk of all-cause death (HR=1.45, 95% CI: 0.49–4.26, P=0.501).</p><p>Conclusions: The findings suggest that physical frailty assessment serves as a stratifying tool to identify high-risk populations for post-discharge clinical events among ambulant elderly patients with AMI.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 87 (4), 490-497, 2023-03-24

    一般社団法人 日本循環器学会

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