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

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

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.

Design

Observational prospective study.

Setting

Multicenter registry conducted in 44 hospitals in Spain.

Participants

Consecutive patients with ACS aged 80≥years.

Measurements

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.

Results

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).

Conclusions

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.

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Acknowledgments

We thank CERCA Programme / Generalitat de Catalunya for institutional support.

Funding

Funding: The LONGEVO-SCA project has received funding form the Spanish Society of Cardiology.

Author information

Authors and Affiliations

  1. Hospital Universitari de Bellvitge. IDIBELL L’Hospitalet de Llobregat, Barcelona, Spain

    O. Rodríguez-Queraltó, F. Formiga, O. Alegre, L. Vicent & Albert Ariza-Solé

  2. Hospital Moisès Broggi. Sant Joan Despí, Barcelona, Spain

    A. Carol

  3. Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain

    C. Llibre & E. Bernal

  4. Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain

    M. Martínez-Sellés

  5. CIBERCV. Universidad Europea. Universidad Complutense, Murcia, Spain

    M. Martínez-Sellés

  6. Hospital Universitario Virgen de la Arrixaca. IMIB-Arrixaca, CIBER-CV, Murcia, Spain

    F. Marín

  7. Hospital Universitario La Princesa, Madrid, Spain

    P. Díez-Villanueva

  8. Hospital Clínico de Valencia, Valencia, Spain

    J. Sanchis & C. Bonanad

  9. Hospital General de Albacete, Albacete, Spain

    M. Corbí

  10. Hospital Universitari Josep Trueta, Girona, Spain

    J. Aboal

  11. Hospital de Burgos, Burgos, Spain

    J. Angel Perez-Rivera

  12. Cardiology Department, Bellvitge University Hospital, Feixa Llarga s/n. 08907. L’Hospitalet de Llobregat, Barcelona, Spain

    Albert Ariza-Solé

Authors
  1. O. Rodríguez-Queraltó
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  2. F. Formiga
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  3. A. Carol
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  4. C. Llibre
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  5. M. Martínez-Sellés
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  6. F. Marín
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  7. P. Díez-Villanueva
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  8. J. Sanchis
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  9. C. Bonanad
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  10. M. Corbí
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  11. J. Aboal
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  12. J. Angel Perez-Rivera
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  13. O. Alegre
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  14. E. Bernal
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  15. L. Vicent
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  16. Albert Ariza-Solé
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Corresponding author

Correspondence to Albert Ariza-Solé.

Ethics declarations

Conflict of interest: The authors declare no conflict of interest.

Ethical statement: All patients or their representatives signed an informed consent before being recruited for the study. Confidential information of the patients was protected according to national normative. The LONGEVO-SCA protocol was approved by the reference Clinical Research Ethics Committee (Bellvitge University Hospital (IRB00005523)).

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Rodríguez-Queraltó, O., Formiga, F., Carol, A. et al. Impact of Diabetes Mellitus and Frailty on Long-Term Outcomes in Elderly Patients with Acute Coronary Syndromes. J Nutr Health Aging 24, 723–729 (2020). https://doi.org/10.1007/s12603-020-1409-1

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  • DOI: https://doi.org/10.1007/s12603-020-1409-1

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