Association of frailty with all-cause mortality and bleeding among elderly patients with acute myocardial infarction: a systematic review and meta-analysis

作     者：Prapaipan Putthapiban Wasawat Vutthikraivit Pattara Rattanawong Weera Sukhumthammarat Napatt Kanjanahattakij Jakrin Kewcharoen Aman Amanullah Prapaipan Putthapiban;Wasawat Vutthikraivit;Pattara Rattanawong;Weera Sukhumthammarat;Napatt Kanjanahattakij;Jakrin Kewcharoen;Aman Amanullah

作者机构：Department of Internal MedicineEinstein Medical CenterPhiladelphiaPAUSA Department of Internal MedicineTexas Tech University Health Sciences CenterLubbockTxUSA University of Hawaii Internal Medicine Residency ProgramHonoluluHIUSA Institute of Heart and Vascular HealthEinstein Medical CenterPhiladelphiaPAUSA 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2020年第17卷第5期

页      面：270-278,I0005页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Acute myocardial infarction Bleeding Frailty Mortality 

摘      要：Background Frailty is a multidimensional syndrome that reflects the physiological reserve of *** is related to unfavorable outcomes in various cardiovascular *** conducted a systematic review and meta-analysis of the association of frailty with all-cause mortality and bleeding after acute myocardial infarction(AMI)in the *** We comprehensively searched the databases of MEDLINE and EMBASE from inception to March *** studies that reported mortality and bleeding in AMI patients who were evaluated and classified by frailty status were *** from each study were combined using the random-effects,generic inverse variance method of Der Simonian and Laird to calculate hazard ratio(HR),and 95%confidence interval(CI).Results Twenty-one studies from 2011 to 2019 were included in this meta-analysis involving 143,301 subjects(mean age 75.33-year-old,60.0%male).Frailty status was evaluated using different methods such as Fried Frailty *** was statistically associated with increased early mortality in nine studies(pooled HR=2.07,95%CI:1.67-2.56,P0.001,I^2=41.2%)and late mortality in 11 studies(pooled HR=2.30,95%CI:1.70-3.11,P0.001,I^2=65.8%).Moreover,frailty was also statistically associated with higher bleeding in 7 studies(pooled HR=1.34,95%CI:1.12-1.59,P0.001,I^2=4.7%).Conclusion Frailty is strongly and independently associated with bleeding,early and late mortality in elderly with *** assessment should be considered as an additional risk factor and used to guide toward personalized treatment strategies.