Impact of Diabetes Mellitus and Frailty on Long-Term Outcomes in Elderly Patients with Acute Coronary Syndromes

• DOI: 10.1007/s12603-020-1409-1
• Publication Date: 2020-06-06T08:02:38Z
• Authors: O. Rodríguez-Quer...; F. Formiga; A. Carol; C. Llibre; M. Martínez-Sellés; F. Marín; P. Díez-Villanueva; J. Sanchis; C. Bonanad; M. Corbí; J. Aboal; J. Angel Perez-Ri...; O. Alegre; E. Bernal; L. Vicent; Albert Ariza-Solé
• Keywords: Male; Frail Elderly; Enfermedad cardiovascular; Anciano; frailty; 03 medical and health sciences; Elderly; 0302 clinical medicine; Diabetes Mellitus; Prevalence; Humans; Síndrome coronario agudo; acute coronary syndromes; Prospective Studies; Acute Coronary Syndrome; Aged, 80 and over; Frailty; Diabetes; Prognosis; mortality; 3. Good health; Sistema endocrino; diabetes mellitus; Female; Ancianos

Diabetes mellitus (DM) and frailty are common in older patients with acute coronary syndromes (ACS). No data exists about its prognostic impact on long-term outcomes and their possible interaction in this setting.Observational prospective study.Multicenter registry conducted in 44 hospitals in Spain.Consecutive patients with ACS aged 80≥years.A comprehensive geriatric evaluation was performed during hospitalization, including frailty assessment by the FRAIL score. The impact of DM and frailty on the incidence of mortality/readmission at 24 months was analysed by a Cox regression model.A total of 498 patients were included (mean age 84.3 years). Prevalence of previous DM was 199/498 (40.0%). The rate of frail patients was 135/498 (27.1%). The incidence of mortality/readmission was higher frail patients (HR 2.49) (both p<0.001). In contrast, DM was not significantly associated to a higher rate of outcomes (HR 1.23, p=0.060) in the whole cohort. Among non-frail patients, patients with DM had a similar incidence of mortality or readmission (p=0.959). In contrast, among frail patients, DM was significantly associated with a higher incidence of events (HR 1.51, p=0.034).Unlike frailty status, DM was not associated to poorer long-term outcome in elderly patients with ACS. Among frail patients the presence of DM seems to provide additional prognostic information.