Author + information
- Giovanni Benfari,
- Clémence Antoine,
- Wayne Miller,
- Hector Michelena,
- Vuyisile Nkomo and
- Maurice Sarano
Background: Frailty is considered of poor prognosis and can be estimated by deficit accumulation using frailty index (FI). In documented left ventricular dysfunction (LVD), it is uncertain whether FI is a surrogate and consequence of advanced hemodynamic alterations or is an incremental marker of excess mortality.
Methods: All patients diagnosed with LVD (EF <50%) at Mayo Clinic 2003-2011 were studied. FI was calculated from activities of daily living, body mass index, and comorbidities. Organic valve, myocardial, pericardial diseases were excluded.
Results: Among enrolled patients (n=13854, age 68±14 years, 31% female, EF 36 ±10%) FI was 20±11%, low (≤10%) in 2466, intermediate (11-30%) in 3774, and high (>30%) in 6240 patients. Hemodynamic measures weakly correlated to FI (all R2<0.05), and together modestly related to FI (R2 0.13). During follow-up 8694 patients died. Compared to age, sex and all hemodynamic and heart failure measures, FI was incremental prognostic marker (p<0.0001) with hazard ratio little affected by comprehensive adjustment for age, all heart failure and hemodynamic measures (from 1.27 per 5% increase, unadjusted to 1.17[1.16-1.19], p<0.0001 adjusted). FI was a powerful predictor of excess mortality after LVD diagnosis (Figure).
Conclusions: FI is 1-simple to acquire from patient-reported activities, 2-Weakly related to hemodynamic and heart failure status but 3-strongly, independently and incrementally predictive of mortality in LVD patients.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Making Progress in Understanding Heart Failure
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1123-265
- 2017 American College of Cardiology Foundation