Relationship between the level of frailty and clinical severity of acute coronary syndrome in the elderly

Abstract

Recent studies in Canada, Spain, the USA and China found that the frequency of frailty in the elderly with acute coronary syndrome (ACS) is as high as 43.18%. Higher levels of frailty in these patients are related to undesirable clinical outcomes. In Brazil, there is a gap in the literature regarding the relationship between frailty and clinical severity of ACS in the elderly. This knowledge could determine which dimensions of frailty are related to the clinical signs of ACS, thereby guiding more predictive and more assertive therapeutic approaches. Objective: To evaluate the relationship between the level of frailty and the clinical severity of ACS in the elderly. Materials and methods: An observational, analytical, cross-sectional study will be performed with 110 patients hospitalized for ACS at the Cardiology units of Hospital São Paulo. The independent variable of the study will be the level of frailty. The dependent variable will be the clinical severity of the patient, represented by the risk of adverse cardiac events. The covariates will be classified as sociodemographic and clinical. Frailty will be measured through the Tilburg Frailty Scale (TFI), including the physical, psychological and social domains. The clinical severity of the patient will be considered a continuous variable, according to the risk scores of cardiac events. Global Registry of Acute Coronary Events (GRACE) for SCA, TIMI for unstable angina/non-ST elevation acute myocardial infarction (STEMI) and TIMI for ST-elevation acute myocardial infarction (STEMI). The sociodemographic and clinical variables will be analysed in a descriptive way, through measures of central tendency (mean or median) and dispersion (standard deviation or interquartile range). The relationships between the TFI scores and the GRACE, TIMI Risk scores for AI/Non-STEMI and TIMI Risk for STEMI will be verified using simple and multiple linear regression, with control for sociodemographic and clinical covariables.