Treatment for frail heart patients improves survival rates
Dr Marius Roman
A new study shows that heart patients treated with revascularisation have better survival rates, even with a high risk of frailty.
Revascularisation is a treatment which may include surgical stenting and aims to restore blood flow to the heart when it is limited or blocked, in patients with Acute Coronary Syndrome (ACS).
Frailty, which describes the ability of people to perform everyday tasks and recover from stressful events, is common in people with ACS, and there has been uncertainty about the risks and benefits of providing invasive treatments.
A study led by researchers in the University of Leicester’s Department of Cardiovascular Sciences shows that patients deemed high and intermediate risk of frailty on the Hospital Frailty Risk Score can benefit from revascularisation.
The findings, published in the European Heart Journal, could pave the way for improved treatment plans and extend many lives.
Dr Marius Roman, an NIHR Clinical Lecturer in Cardiac Surgery at the University working with the Leicester heart failure research team and international experts in large population studies said: “Our longitudinal study looked at 565,378 ACS patients over five years, of whom 11.6% (65,522) were at intermediate risk, and 4.7% (26,504) were at high risk of frailty.
“Intermediate and high frailty risks were associated with the reduced likelihood of receiving echocardiography or angiography to check the heart and nearby blood vessels and subsequent revascularisation to help fix this, compared to those considered to have low frailty levels.
“But analysis suggests that revascularisation treatment resulted in a higher absolute reduction in cardiovascular mortality in high and intermediate frail risk patients compared to low risk at one-year post-ACS. This means that treating people with frailty and variability in care improves their life expectancy and health-related outcomes.
“With an ageing population, the number of people presenting with frailty and ACS will likely increase, but this research suggests that revascularisation could make a significant improvement in this vulnerable group and addresses a previously unknown gap in our knowledge. In addition, it highlights geographical variations taking place in treatment for ACS."
The study was funded by the British Heart Foundation and the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre (BRC) with support from the New Zealand Heart Foundation Heart Health Research Trust fellowship.