The relationship between frailty syndrome and quality of life in older patients following acute coronary syndrome

Abstract

Purpose: Elderly patients with ST-segment-elevation myocardial infarction (STEMI) have a high risk of mortality, which is particularly high in the first 30 days. Quality of life (QoL) and risk-benefit assessments are of pivotal importance in the elderly. The objective of this study is to assess the relationship between frailty syndrome (FS) and QoL in patients following acute coronary syndrome (ACS) non-ST elevation myocardial infarction (NSTEMI).

Patients and Methods: The study involved 100 patients (61 men, 39 women, the average age: M ± SD =66.12±10.92 years). The study used standardized research tools: a questionnaire to assess QoL (World Health Organization Quality of Life Scale Brief version), and a questionnaire to assess FS (Tilburg Frailty Indicator).

Results: FS occurred in 80% of patients after ACS. FS has a negative impact on the QoL of patients with ACS. The most important domain of FS in the studied group was the psychological: M ± SD=2.2±0.75 points. The greater FS in the physical domain, the lower the QoL in all areas. The greater FS in the social domain, the lower the QoL in psychological and social fields. Self-evaluation of patient QoL was M ± SD=3.68±0.71 points. Self-assessment of health was M ± SD=2.59±0.98 points.

Conclusion: Patients with a coexisting FS have a poorer QoL in the physical, psychological, social, and environmental fields. For a multidisciplinary team, these findings can help make the therapeutic decision for frail patients who have poor QoL. Frailty among elderly patients with ACS can be considered as a determinant of high risk of adverse outcomes.

Keywords:

• frailty syndrome
• quality of life
• acute coronary syndrome
• Tilburg Frailty Indicator

Acknowledgments

There were no contributors to the article other than the authors and there was no writing assistance regarding this paper. This study was conducted under a research project funded by the Ministry of Science and Higher Education in Poland as a part of a statutory grant of the Wroclaw Medical University for maintaining research potential (number ST.E020.17.050).

Abbreviations list

ACC, American College of Cardiology; ACS, acute coronary syndrome; AGS, the American Geriatrics Society; AHA, American Heart Association; BMI, body mass index; CAD, coronary artery disease; CHS, Cardiovascular Health Study scale; CI, cognitive impairment; CVD, cardiovascular diseases; DTBT, door-to-balloon time; ESC, the European Society of Cardiology; FS, frailty syndrome; GRACE, the Global Registry of Acute Coronary Events; IFFANIAM, The Impact of frailty and functional status in elderly patients with ST-segment elevation myocardial infarction undergoing primary angioplasty; MacNew HD-HRQL, the MacNew Heart Disease Health-related QoL; NSTEMI, non-ST elevation myocardial infarction; QoL, quality of life; PD, physical domain of TFI; PsD, psychosocial domain of TFI; SD, social domain of TFI; SHARE-FI, the Survey of Health, Ageing and Retirement in Europe index; STEMI, ST-segment-elevation myocardial infarction; STROBE, STrengthening the Reporting of OBservational studies in Epidemiology; TFI, Tilburg Frailty Indicator; TIMI, the Thrombolysis In Myocardial Infarction; WHOQOL-BREF, World Health Organization Quality of Life Scale Brief Version.

Data sharing statement

The authors confirm that all data underlying the findings described in this manuscript are fully available to all interested researchers upon request.

Author Contributions

All authors contributed toward data analysis, drafting and critically revising the paper, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.