Modified frailty as a novel factor in predicting the response to cardiac resynchronization in the elderly population

Agnieszka Mlynarska,1,2 Rafal Mlynarski,2,3 Czeslaw Marcisz,1 Krzysztof S Golba2,3 1Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland; 2Department of Electrocardiology, Upper Silesian Heart Centre, Katowice, Poland; 3Departme...

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Autores principales:	Mlynarska A, Mlynarski R, Marcisz C, Golba KS
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Cardiac resynchronization Frailty syndrome Heart failure Outcomes Responders Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/d0bf1f5a11a247e5a07470a15413d2dc
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spelling	oai:doaj.org-article:d0bf1f5a11a247e5a07470a15413d2dc2021-12-02T05:02:45ZModified frailty as a novel factor in predicting the response to cardiac resynchronization in the elderly population1178-1998https://doaj.org/article/d0bf1f5a11a247e5a07470a15413d2dc2019-02-01T00:00:00Zhttps://www.dovepress.com/modified-frailty-as-a-novel-factor-in-predicting-the-response-to-cardi-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Agnieszka Mlynarska,1,2 Rafal Mlynarski,2,3 Czeslaw Marcisz,1 Krzysztof S Golba2,3 1Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland; 2Department of Electrocardiology, Upper Silesian Heart Centre, Katowice, Poland; 3Department of Electrocardiology and Heart Failure, School of Health Sciences, Medical University of Silesia, Katowice, Poland Background: The response to cardiac resynchronization therapy (CRT) is an important element of the treatment of advanced heart failure, especially in the geriatric population. The aim of the study was to examine the impact of frailty syndrome on the response to treatment with CRT. Methods: Two hundred and forty-six patients of 60 years or older (aged 73.35±6.95; 22.4% women) with an implanted CRT were included in this single-center prospective study. There was a 12-month follow-up. The Tilburg Frailty Indicator was used to determine frailty (5 or more points). The response to CRT was evaluated based on an analysis of clinical criteria. Results: One hundred and sixty-nine of 246 (68.9%) patients were found to be clinical CRT responders. Frailty syndrome was recognized in 173 (70.32%). There were 63.0% responders in the frailty-affected group, whereas there were statistically more responders (79.5%) in the robust group (P=0.0116). In the logistic regression, frailty emerged as an independent predictor of the response to CRT (OR=0.81, 95% CI=0.71–0.92; P=0.0008). The area under the curve of the ROC curve for frailty in the responders to CRT was 0.62. The cut-off value for a designation of frailty was 6 (P=0.0014). Conclusion: Frailty is a novel independent factor that can be used to predict the clinical response to CRT in the elderly population. Modifying the level of recognition in the Tilburg Frailty Indicator can improve the prediction of a response to CRT. Keywords: cardiac resynchronization, frailty syndrome, heart failure, outcomes, respondersMlynarska AMlynarski RMarcisz CGolba KSDove Medical PressarticleCardiac resynchronizationFrailty syndromeHeart failureOutcomesRespondersGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 14, Pp 437-443 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cardiac resynchronization Frailty syndrome Heart failure Outcomes Responders Geriatrics RC952-954.6
spellingShingle	Cardiac resynchronization Frailty syndrome Heart failure Outcomes Responders Geriatrics RC952-954.6 Mlynarska A Mlynarski R Marcisz C Golba KS Modified frailty as a novel factor in predicting the response to cardiac resynchronization in the elderly population
description	Agnieszka Mlynarska,1,2 Rafal Mlynarski,2,3 Czeslaw Marcisz,1 Krzysztof S Golba2,3 1Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland; 2Department of Electrocardiology, Upper Silesian Heart Centre, Katowice, Poland; 3Department of Electrocardiology and Heart Failure, School of Health Sciences, Medical University of Silesia, Katowice, Poland Background: The response to cardiac resynchronization therapy (CRT) is an important element of the treatment of advanced heart failure, especially in the geriatric population. The aim of the study was to examine the impact of frailty syndrome on the response to treatment with CRT. Methods: Two hundred and forty-six patients of 60 years or older (aged 73.35±6.95; 22.4% women) with an implanted CRT were included in this single-center prospective study. There was a 12-month follow-up. The Tilburg Frailty Indicator was used to determine frailty (5 or more points). The response to CRT was evaluated based on an analysis of clinical criteria. Results: One hundred and sixty-nine of 246 (68.9%) patients were found to be clinical CRT responders. Frailty syndrome was recognized in 173 (70.32%). There were 63.0% responders in the frailty-affected group, whereas there were statistically more responders (79.5%) in the robust group (P=0.0116). In the logistic regression, frailty emerged as an independent predictor of the response to CRT (OR=0.81, 95% CI=0.71–0.92; P=0.0008). The area under the curve of the ROC curve for frailty in the responders to CRT was 0.62. The cut-off value for a designation of frailty was 6 (P=0.0014). Conclusion: Frailty is a novel independent factor that can be used to predict the clinical response to CRT in the elderly population. Modifying the level of recognition in the Tilburg Frailty Indicator can improve the prediction of a response to CRT. Keywords: cardiac resynchronization, frailty syndrome, heart failure, outcomes, responders
format	article
author	Mlynarska A Mlynarski R Marcisz C Golba KS
author_facet	Mlynarska A Mlynarski R Marcisz C Golba KS
author_sort	Mlynarska A
title	Modified frailty as a novel factor in predicting the response to cardiac resynchronization in the elderly population
title_short	Modified frailty as a novel factor in predicting the response to cardiac resynchronization in the elderly population
title_full	Modified frailty as a novel factor in predicting the response to cardiac resynchronization in the elderly population
title_fullStr	Modified frailty as a novel factor in predicting the response to cardiac resynchronization in the elderly population
title_full_unstemmed	Modified frailty as a novel factor in predicting the response to cardiac resynchronization in the elderly population
title_sort	modified frailty as a novel factor in predicting the response to cardiac resynchronization in the elderly population
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/d0bf1f5a11a247e5a07470a15413d2dc
work_keys_str_mv	AT mlynarskaa modifiedfrailtyasanovelfactorinpredictingtheresponsetocardiacresynchronizationintheelderlypopulation AT mlynarskir modifiedfrailtyasanovelfactorinpredictingtheresponsetocardiacresynchronizationintheelderlypopulation AT marciszc modifiedfrailtyasanovelfactorinpredictingtheresponsetocardiacresynchronizationintheelderlypopulation AT golbaks modifiedfrailtyasanovelfactorinpredictingtheresponsetocardiacresynchronizationintheelderlypopulation
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Modified frailty as a novel factor in predicting the response to cardiac resynchronization in the elderly population

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