PhD Scientific Days 2022
Budapest, 6-7 July 2022
Clinical Medicine VI. (Poster discussion will take place on the terrace of the room during the Coffee Break)
The prevalence and importance of frailty in CRT patients
Előadó neve
Dr. Kuthi, Luca
Előadó munkahelye
Semmelweis University Heart and Vascular Center, Budapest, Hungary
Előadó telefonszáma
06302875885
Előadó e-mail címe
lucakuthi@gmail.com
Az előadás címe
The prevalence and importance of frailty in CRT patients
Szerző(k) neve és munkahelye
Walter Richard Shwertner1, Boglárka Veres1, Eperke Dóra Merkel1, Richard Masszi1, Anett Behon1, Attila Kovács1, István Osztheimer1, Endre Zima1, Levente Molnár1, László Gellér1, Annamária Kosztin1, Béla Merkely1
1: Semmelweis University Heart and Vascular Center, Budapest
Bemutatás módja
Szóbeli
Szekció
Clinical Medicine VI. (Poster discussion will take place on the terrace of the room during the Coffee Break)
Language of the presentation
English
Preferred session
Clinical Medicine
Összefoglaló szövege
Introduction: Frailty is a complex clinical syndrome associated with ageing and comorbidities resulting from multiple organ impairment by losing homeostatic reserves and increased vulnerability to physiological decompensation. Frailty can be measured by quantifying the "vulnerability status" by the range of comorbidities.
Aims: We assessed the long-term all-cause mortality based on Frailty Index (FI) among patients who underwent Cardiac Resynchronization Therapy (CRT) implantation.
Methods: We calculated patients' FI individually using 30 clinical parameters from our retrospective single centre large-scale registry. The applied clinical features incorporated patients’ medical history, anthropometric-, laboratory and echocardiographic parameters. Based on previous studies, patients with FI ≤0.210 were classified as non-frail, and patients above that value were considered frail. Frail patients were divided into two different subgroups by a FI increment of 0.1 based on the Rockwood method. Primary endpoint was all-cause mortality, log-rank and Cox multivariate analysis were performed.
Results: Among 1010 included patients, 58 (6%) were considered as Non-frail, while 245 (24%) and 707 (70%) participants were categorized to F1- and F2 groups. Patients in F2 group were older, had worse laboratory parameters as higher creatinine, uric acid, lower sodium or hemoglobin levels and more comorbidities than patients of Non-frail or F1 groups. During the median follow-up time of 4.4 years, 17 (29%) patients in the Non-frail group, 103 (42%) in Frail group 1 and 479 (68%) in the Frail group 2 reached the primary endpoint. Non-frail patients showed the best outcome, and patients in the Frail group 1 demonstrated a 46% (HR 0.46, 95%CI 0.39-0.55; p<0.001) lower all-cause mortality risk compared to Frail group 2. In the total cohort, mortality predictors were also assessed, NYHA functional class, serum sodium, creatinine and TAPSE were identified as independent predictors of all-cause mortality.
Conclusion: By calculating individual frailty index among CRT patients, distinct groups could be identified, of which mortality differed significantly. Those with the highest Frailty index demonstrated the worse outcome compared to lower index or non-frail patients. Frailty index can help selecting the most vulnerable patients, requiring a strict follow-up.
University and Doctoral School
Semmelweis University, Doctoral School of Theoretical and Translational Medicine
Supervisor
Annamária Kosztin, Béla Merkely
Publication of my abstract
I do not give consent to the publication of my abstract on the website of the congress.
Kind
Szabad
Status
elfogadva
Accepted presentation method
szóbeli
Előadás fájl jóváhagyás
nem rendelkezett róla
Előadó
6891
Start
09:15
End
09:30
Authors (legacy)
Walter Richard Shwertner1, Boglárka Veres1, Eperke Dóra Merkel1, Richard Masszi1, Anett Behon1, Attila Kovács1, István Osztheimer1, Endre Zima1, Levente Molnár1, László Gellér1, Annamária Kosztin1, Béla Merkely1
1: Semmelweis University Heart and Vascular Center, Budapest