Coronary disease & ACSCohort study
Revascularization in frail patients with acute coronary syndromes: a retrospective longitudinal study
- Retrospective cohort study
- instrumental variable analysis
Authors' conclusion
Revascularization is associated with short- and long-term survival benefits in people at intermediate and high risk of frailty after adjustment for measured and unmeasured confounders.
Study context
- Population
- Patients with acute coronary syndrome (ACS) in England, 2010–2015 (Hospital Episode Statistics linked to ONS mortality data)
- Participants
- 565,378 patients
- Exposure
- Revascularization vs no revascularization, by frailty risk
- Intermediate frailty riskn = 65,522
- High frailty riskn = 26,504
- Outcome
- Average treatment effect of revascularization on CV mortality
- Follow-up
- Up to 5 years
Main finding
As reported in the abstract
CV mortality reduction with revascularization · 1-year post-ACS
- Revascularization resulted in a higher absolute reduction in CV mortality in high and intermediate frail risk patients compared with low risk (instrumental variable analysis)
Observational data: associations, not effects.
Further findings
CV death · up to 5 years
Care and outcomes by frailty risk
- Intermediate and high frailty risk associated with reduced likelihood of echocardiography, invasive angiography or revascularization and increased mortality and MACE vs low frailty risk
Original publication
Revascularization in frail patients with acute coronary syndromes: a retrospective longitudinal study. Eur Heart J. Published 16 November 2024. doi:10.1093/eurheartj/ehae755
Summarised from the published abstract; every number is checked against it