Summary of most relevant studies of frailty in cardiovascular disease
| Authors | Study cohort and size | Frailty criteria | Findings |
|---|---|---|---|
| Chin et al 51 | Age 69–89, n=450 | Inactivity combined with low energy intake, weight loss or low body mass index | 62% of frail patients had coexisting cardiovascular disease compared with 28% of the ‘non-frail’ |
| Newman et al 23 | Community dwelling older adults, n=4735 | 3/5 of: self-reported weight loss, low grip strength, low energy, slow gait speed, and low physical activity | Threefold increase in frailty in patients with cardiovascular disease |
| Klein et al 52 | Population based study of mid-western adults, n=2515 | Gait speed, handgrip strength, peak respiratory flow rate, ability to stand from a sitting position without using arms, and corrected visual acuity | Increase in frailty score by 1/5 was associated with a 35% increase in the presence of cardiovascular disease |
| Woods et al 25 | Women aged 65–79, n=40 657 | Self-reported muscle weakness/impaired walking, exhaustion, low physical activity, and unintended weight loss | Baseline frailty independently predicted risk of death (HR 1.71, 95% CI 1.48 to 1.97) |
| Mcnallan et al 27 | Heart failure, n=448 | 3 or more of the following: unintentional weight loss, exhaustion, weak grip strength, and slowness and low physical activity | Frailty was associated with a 92% increased risk of emergency department visits and 65% increased risk of hospitalisation |
| Polidoro et al 28 | Patients with AF, n=140 | Standard score of accumulated deficits | Increased number of frail patients in AF cohort (88.6% vs 67.1%, p=0.004) |
| Matsuzawa et al 12 | Patients with NSTEMI and >75 years old, n=472 | Gait speed | Gait speed was a significant independent predictor of cardiovascular events |
| Sunderman et al 53 | CABG, valve surgery or TAVI, n=400 | CAF score | Significant correlation between frailty score and 30-day mortality |
| Schoenenberger et al 39 | TAVI, n=106 | Frailty index | Frailty strongly predicted functional decline after TAVI |
| Singh et al 46 | >65 years undergoing PCI, n=628 | Fried frailty scale | Frailty was associated with mortality/MI at 3 years (HR 2.61, 95% CI 1.52 to 4.50) |
AF, atrial fibrillation; CAF, Comprehensive Assessment of Frailty; CABG, coronary artery bypass graft; MI, myocardial infarction; NSTEMI, non-ST-elevation myocardial infarction; PCI, percutaneous coronary intervention; TAVI, transcatheter aortic valve implantation.