Title |
Utility of Frailty Assessment for Elderly Patients Undergoing Cardiac Resynchronization Therapy
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Published in |
JACC: Clinical Electrophysiology, September 2017
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DOI | 10.1016/j.jacep.2017.06.012 |
Pubmed ID | |
Authors |
Maciej Kubala, Laurence Guédon-Moreau, Frédéric Anselme, Didier Klug, Geneviève Bertaina, Sarah Traullé, Otilia Buiciuc, Arnaud Savouré, Momar Diouf, Jean-Sylvain Hermida |
Abstract |
The aim of this study was to evaluate the impact of frailty in the elderly on response to cardiac resynchronization therapy (CRT). CRT has been shown to improve symptoms and outcome of patients with congestive heart failure (HF) and impaired left ventricular ejection fraction (LVEF). The impact of frailty on the results of CRT is unknown. Frailty defined as <14 of 17 points using the ONCODAGE (Outil de dépistage gériatrique en oncologie) G8 score was assessed before device implantation in candidates for CRT who were >70 years of age. The primary endpoint was the response to CRT, defined as an improvement of >5% of the LVEF and the absence of hospitalization for HF or cardiovascular death at 9 months. Ninety-two of 151 included patients (61%) were frail, and 89 (59%) were responders. Frailty was more frequent in nonresponders: 45 of 62 (73%) versus 47 of 89 (53%) (p = 0.014) and was identified as an independent predictor of nonresponse to CRT (R = 0.30; 95% confidence interval: 0.02 to 0.59; p = 0.039). Frailty was associated with a higher cumulative probability of hospitalization for HF (log-rank p = 0.032) and of all-cause death (log-rank p = 0.033). A G8 score <10.25 correlated with hospitalization for HF or death at 9 months (area under the curve: 0.75; 95% confidence interval: 0.63 to 0.87; cutoff <10.25; 77% sensitivity, 63% specificity). Frailty is as an independent predictor of nonresponse to CRT. Frail patients implanted with CRT devices have a higher risk of hospitalization for HF and mortality. Routine comprehensive geriatric assessment at the time of screening for device therapy should be recommended to optimize management. (Frailty Score Assessment for Elderly Patients Undergoing Cardiac Resynchronization Therapy [FRAILTY]; NCT02369419). |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 9 | 15% |
Spain | 8 | 13% |
Canada | 8 | 13% |
United Kingdom | 7 | 11% |
Australia | 2 | 3% |
Colombia | 2 | 3% |
Poland | 1 | 2% |
France | 1 | 2% |
Nigeria | 1 | 2% |
Other | 8 | 13% |
Unknown | 15 | 24% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 39 | 63% |
Scientists | 13 | 21% |
Practitioners (doctors, other healthcare professionals) | 9 | 15% |
Science communicators (journalists, bloggers, editors) | 1 | 2% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 42 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 5 | 12% |
Student > Bachelor | 4 | 10% |
Researcher | 4 | 10% |
Professor | 3 | 7% |
Student > Master | 3 | 7% |
Other | 4 | 10% |
Unknown | 19 | 45% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 12 | 29% |
Agricultural and Biological Sciences | 2 | 5% |
Engineering | 2 | 5% |
Social Sciences | 2 | 5% |
Psychology | 1 | 2% |
Other | 2 | 5% |
Unknown | 21 | 50% |