| Background and ObjectPopulation aging is an important public health issue worldwide.With the deepening of population ageing in China,the common diseases and illnesses of the elderly are attracting more and more attention.Frailty is a common geriatric syndrome,a specific state of gradually declining physical function in the elderly.It is a clinical syndrome in which the reserve and function of several physiological systems of the body are reduced,resulting in increased vulnerability to stressful events.Frailty provides a more realistic and objective reflect of the health problems and medical needs of older people compared with their actual age.Improving the medical staff’s understanding of frailty will effectively identify factors affecting poor clinical prognosis and better delay the onset and progression of functional decline and chronic disease in older people.Coronary heart disease,short for coronary atherosclerotic heart disease,is a heart disease caused by atherosclerosis of the coronary arteries causing luminal narrowing or occlusion,resulting in myocardial ischaemia,hypoxia or necrosis.With the gradual change in lifestyle of our population,the incidence of coronary heart disease is increasing.Patients with severe or unstable coronary heart disease require PCI treatment,which can rapidly dilate coronary vessels and restore blood flow,but patients can still experience adverse cardiac events or exacerbations after the procedure due to various cardiovascular risk factors.Frailty and coronary artery disease often co-exist in elderly patients and both interact with each other.Frailty is strongly associated with the development and poor prognosis of coronary artery disease and has been shown to be a strong influence on the prognosis of elderly patients with coronary artery disease after PCI.Early identification and intervention of patients with frailty can improve the prognosis of elderly patients with coronary artery disease after PCI.ObjectiveThis study investigated the current status of frailty in elderly patients after PCI for coronary artery disease,explored the factors associated with frailty in elderly patients undergoing PCI for coronary artery disease,and explored the relationship between each relevant factor and debilitation to provide a basis for their early identification and early intervention to improve their prognosis.MethodWe collected 235 elderly coronary heart disease patients aged ≥65 years who were hospitalized in the Department of Geriatrics and the Department of Cardiovascular Medicine of University from November 2021 to June 2022,and divided them into debilitated and non-debilitated groups(non-debilitated and pre-debilitated)according to the assessment results of Frailty phenotype.General information,hematology indexes,hematology derivative indexes,and cardiac ultrasound results were compared between the two groups separately to find statistically significant indicators between the two groups.Logistic regression analysis was used to the above statistically significant indicators to explore the factors associated with combined debilitation in elderly patients with coronary artery disease after PCI.p<0.05 was considered a statistically significant difference.Results1.Among the 235 elderly patients after PCI for coronary artery disease,98 were in the frail group(41.7%),and 137 in the non-debilitated group(58.3%).2.The debilitated group was older and had higher levels of white blood cells,neutrophil count,creatinine,C-reactive protein,BNP,neutrophil/lymphocyte ratio(NLR),and monocyte/lymphocyte ratio(MLR)compared to the non-debilitated group.Red blood cell count,haemoglobin,albumin,25(OH)D,left ventricular ejection fraction(LVEF),output per minute levels were lower and were prone to comorbid chronic obstructive pulmonary disease(COPD),chronic heart failure,chronic renal insufficiency and osteoporosis.The difference was statistically significant(p < 0.05).3.Taking the above statistically different factors as independent variables and frailty as the dependent variable,Logistic regression analysis showed that Age(OR:4.213,95%CI:1.576-8.543,P=0.016)、combined chronic heart failure(OR:3.156,95%CI:1.035-9.658,P=0.034)、NLR(OR:1.259,95%CI:1.029-1.541,P=0.001)、Haemoglobin(OR:0.097,95%CI:0.978-1.001,P=0.037)、albumin(OR:0.273,95%CI:0.927-1.721,P=0.001)、25(OH)D(OR:0.567,95%CI0.445-0.778,P=0.012)、left atrial internal diameter(OR:1.071,95%CI:1.021-1.153,P=0.006)may be related to frailty in elderly patients undergoing PCI for Coronary atherosclerotic heart disease.4.Conclusion1.The prevalence of frailty is higher in elderly patients with Coronary atherosclerotic heart disease after PCI.2.Age,combined chronic heart failure,haemoglobin,albumin,25(OH)D,NLR,left atrial internal diameter as influencing factors associated with combined debilitation in elderly patients undergoing PCI for Coronary atherosclerotic heart disease.3.Age,combined chronic heart failure,NLR,and left atrial internal diameter are risk factors for combined debilitation in elderly patients undergoing PCI for coronary artery disease.4.Haemoglobin,albumin and 25(OH)D were protective factors for combined debilitation in elderly patients undergoing PCI for Coronary atherosclerotic heart disease. |
PDF Full Text Request