Impact of hypoalbuminemia, frailty, and body mass index on early prognosis in older patients (≥85 years) with ST-elevation myocardial infarction.
BACKGROUND
The optimal treatment strategies for acute ST-elevation myocardial infarction (STEMI) in older patients are unclear because of the high risk of mortality in this population. Hypoalbuminemia, frailty, and body mass index (BMI) have been reported to worsen the prognosis of some older patients with cardiovascular disease, but the specific impact of these factors on the prognosis after STEMI is poorly understood. The aim of this study was to investigate the impact of these factors on early outcomes in patients aged ≥85 years with acute STEMI.


METHODS
Sixty-two consecutive eligible patients aged ≥85 years (mean age, 88.1±2.5 years; age range, 85-94 years; female, 41.9%; primary percutaneous coronary intervention, 67.7%) who were admitted to our hospital with STEMI were retrospectively reviewed. Baseline patient characteristics, echocardiographic, electrocardiographic, and laboratory findings, and the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS) score were assessed. The primary endpoint was in-hospital mortality and the secondary endpoint was failure of discharge to home. Independent baseline variables with a p-value of <0.15 in the univariate analyses were included in the multivariate analyses.


RESULTS
Multivariate analysis identified a higher baseline serum troponin I level [p=0.046; odds ratio (OR): 1.02], lower baseline albumin level (p=0.035, OR: 0.16), and CSHA-CFS score ≥6 (p=0.028, OR: 6.38) as independent predictors of in-hospital mortality. Lower BMI (p<0.001, OR: 0.49) and CSHA-CFS frailty score ≥6 (p=0.002, OR: 16.69) were identified as independent predictors of failure of discharge to home.


CONCLUSIONS
These findings indicate that the serum albumin level, CSHA-CFS score, and BMI, in addition to serum troponin I level, have an impact on the early prognosis of older patients with STEMI.
['Sujino|Yasumori|Y|', 'Tanno|Jun|J|', 'Nakano|Shintaro|S|', 'Funada|Shuhei|S|', 'Hosoi|Yoshie|Y|', 'Senbonmatsu|Takaaki|T|', 'Nishimura|Shigeyuki|S|']
D000368:Aged D015992:Body Mass Index D005260:Female D016330:Frail Elderly D017052:Hospital Mortality D006801:Humans D034141:Hypoalbuminemia D007564:Japan D008297:Male D015999:Multivariate Analysis D009203:Myocardial Infarction D010351:Patient Discharge D062645:Percutaneous Coronary Intervention D011379:Prognosis D012189:Retrospective Studies D013318:Stroke Volume D019210:Troponin I
Hypoalbuminemia Frailty Body mass index ST-elevation myocardial infarction In-hospital mortality