nach oben

Erschienen in:

01.06.2020 | Original Article

Frailty and coronary plaque characteristics on optical coherence tomography

verfasst von: Hideo Amano, Ryota Noike, Takayuki Yabe, Ippei Watanabe, Ryo Okubo, Masayuki Koizumi, Mikihito Toda, Takanori Ikeda

Erschienen in: Heart and Vessels | Ausgabe 6/2020

Einloggen, um Zugang zu erhalten

Abstract

The relationship between frailty and plaque characteristics is unclear and was investigated by optical coherence tomography (OCT) in this study. One hundred and four patients undergoing OCT before percutaneous coronary intervention were evaluated. Frailty was defined as a clinical frailty scale score of ≧6. Frailty was found in 16% of the patients (17/104). Compared with the nonfrail patients, frail patients showed significantly lower body mass index (BMI; 20.8 ± 4.0 kg/m² vs. 25.0 ± 3.9 kg/m², P < 0.001), less dyslipidemia [47% (8/17) vs. 75% (65/87), P = 0.023], lower triglycerides levels (95 ± 42 mg/dL vs. 147 ± 81 mg/dL, P < 0.001), less use of statin [29% (5/17) vs. 60% (52/87), P = 0.021], more lipid-rich plaque [82% (14/17) vs. 46% (40/87), P = 0.006] on OCT, more thin-cap fibroatheromas [TCFAs; 71% (12/17) vs. 26% (23/87), P < 0.001], more plaque rupture [53% (9/17) vs. 25% (22/87), P = 0.023], and significantly higher adverse clinical outcomes (death, acute myocardial infarction, acute heart failure, acute coronary syndrome, or target lesion revascularization) [24% (4/17) vs. 6% (5/87), P = 0.007]. The multivariable analysis showed that frailty was one of the independent predictors of TCFAs (odds ratio 8.95, 95% CI 2.40–33.32, P = 0.001). In conclusion, frailty was associated with high plaque vulnerability due to more lipid-rich plaque, TCFAs and plaque rupture on OCT regardless of low BMI, less dyslipidemia and low triglycerides levels, and frail patients had higher adverse clinical outcomes.

Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K (2013) Frailty in elderly people. Lancet 381:752–762PubMed

Bandeen-Roche K, Xue QL, Ferrucci L, Walston J, Guralnik JM, Chaves P, Zeger SL, Fried LP (2006) Phenotype of frailty: characterization in the women's health and aging studies. J Gerontol A Biol Sci Med Sci 61:262–266PubMed

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA, Cardiovascular Health Study Collaborative Research Group (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–156

Xue QL (2011) The frailty syndrome: definition and natural history. Clin Geriatr Med 27:1–15PubMedPubMedCentral

Kulmala J, Nykanen I, Hartikainen S (2014) Frailty as a predictor of all-cause mortality in older men and women. Geriatr Gerontol Int 14:899–905PubMed

Sergi G, Veronese N, Fontana L, De Rui M, Bolzetta F, Zambon S, Corti MC, Baggio G, Toffanello ED, Crepaldi G, Perissinotto E, Manzato E (2015) Pre-frailty and risk of cardiovascular disease in elderly men and women: the Pro.V.A. study. J Am Coll Cardiol 65:976–983PubMed

Khan H, Kalogeropoulos AP, Georgiopoulou VV, Newman AB, Harris TB, Rodondi N, Bauer DC, Kritchevsky SB, Butler J (2013) Frailty and risk for heart failure in older adults: the health, aging, and body composition study. Am Heart J 166:887–894PubMed

Newman AB, Simonsick EM, Naydeck BL, Boudreau RM, Kritchevsky SB, Nevitt MC, Pahor M, Satterfield S, Brach JS, Studenski SA, Harris TB (2006) Association of long-distance corridor walk performance with mortality, cardiovascular disease, mobility limitation, and disability. JAMA 295:2018–2026PubMed

Newman AB, Gottdiener JS, Mcburnie MA, Hirsch CH, Kop WJ, Tracy R, Walston JD, Fried LP (2001) Associations of subclinical cardiovascular disease with frailty. J Gerontol A Biol Sci Med Sci 56:M158–M166PubMed

10.

Mulero J, Zafrilla P, Martinez-Cacha A (2011) Oxidative stress, frailty and cognitive decline. J Nutr Health Aging 15:756–760PubMed

11.

Buckley DI, Fu R, Freeman M, Rogers K, Helfand M (2009) C-reactive protein as a risk factor for coronary heart disease: a systematic review and meta-analyses for the U.S. Preventive Services Task Force. Ann Intern Med 151:483–495PubMed

12.

Huang D, Swanson EA, Lin CP, Schuman JS, Stinson WG, Chang W, Hee MR, Flotte T, Gregory K, Puliafito CA (1991) Optical coherence tomography. Science 254:1178–1181PubMedPubMedCentral

13.

Prati F, Regar E, Mintz GS, Arbustini E, Di Mario C, Jang IK, Akasaka T, Costa M, Guagliumi G, Grube E, Ozaki Y, Pinto F, Serruys PW (2010) Expert review document on methodology, terminology, and clinical applications of optical coherence tomography: physical principles, methodology of image acquisition, and clinical application for assessment of coronary arteries and atherosclerosis. Eur Heart J 31:401–415PubMed

14.

Tearney GJ, Regar E, Akasaka T, Adriaenssens T, Barlis P, Bezerra HG, Bouma B, Bruining N, Cho JM, Chowdhary S, Costa MA, de Silva R, Dijkstra J, Di Mario C, Dudek D, Falk E, Feldman MD, Fitzgerald P, Garcia-Garcia HM, Gonzalo N, Granada JF, Guagliumi G, Holm NR, Honda Y, Ikeno F, Kawasaki M, Kochman J, Koltowski L, Kubo T, Kume T, Kyono H, Lam CC, Lamouche G, Lee DP, Leon MB, Maehara A, Manfrini O, Mintz GS, Mizuno K, Morel MA, Nadkarni S, Okura H, Otake H, Pietrasik A, Prati F, Räber L, Radu MD, Rieber J, Riga M, Rollins A, Rosenberg M, Sirbu V, Serruys PW, Shimada K, Shinke T, Shite J, Siegel E, Sonoda S, Suter M, Takarada S, Tanaka A, Terashima M, Thim T, Uemura S, Ughi GJ, van Beusekom HM, van der Steen AF, van Es GA, van Soest G, Virmani R, Waxman S, Weissman NJ, Weisz G (2012) Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation. J Am Coll Cardiol 59:1058–1072PubMed

15.

Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A (2005) A global clinical measure of fitness and frailty in elderly people. CMAJ 173:489–495PubMedPubMedCentral

16.

Sujino Y, Tanno J, Nakano S, Funada S, Hosoi Y, Senbonmatsu T, Nishimura S (2015) Impact of hypoalbuminemia, frailty, and body mass index on early prognosis in older patients (≥ 85 years) with ST-elevation myocardial infarction. J Cardiol 66:263–268PubMed

17.

Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, Bax JJ, Borger MA, Brotons C, Chew DP, Gencer B, Hasenfuss G, Kjeldsen K, Lancellotti P, Landmesser U, Mehilli J, Mukherjee D, Storey RF, Windecker S (2016) 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 37:267–315

18.

Corti MC, Guralnik JM, Salive ME, Sorkin JD (1994) Serum albumin level and physical disability as predictors of mortality in older persons. JAMA 272:1036–1042PubMed

19.

Korada SKC, Zhao D, Tibuakuu M, Brown TT, Jacobson LP, Guallar E, Bolan RK, Palella FJ, Margolick JB, Martinson JJ, Budoff MJ, Post WS, Michos ED (2017) Frailty and subclinical coronary atherosclerosis: the multicenter aids cohort study (MACS). Atherosclerosis 266:240–247PubMedPubMedCentral

20.

Pilotto A, Gallina P, Panza F, Copetti M, Cella A, Cruz-Jentoft A, Daragjati J, Ferrucci L, Maggi S, Mattace-Raso F, Paccalin M, Polidori MC, Topinkova E, Trifirò G, Welmer AK, Strandberg T, Marchionni N, MPI_AGE Project Investigators (2016) Relation of statin use and mortality in community-dwelling frail older patients with coronary artery disease. Am J Cardiol 118:1624–1630PubMedPubMedCentral

21.

Patel A, Goodman SG, Yan AT, Alexander KP, Wong CL, Cheema AN, Udell JA, Kaul P, D'Souza M, Hyun K, Adams M, Weaver J, Chew DP, Brieger D, Bagai A (2018) Frailty and outcomes after myocardial infarction: insights from the CONCORDANCE registry. J Am Heart Assoc 7:e009859. https://doi.org/10.1161/JAHA.118.009859 CrossRefPubMedPubMedCentral

22.

Strandberg TE, Kolehmainen L, Vuorio A (2014) Evaluation and treatment of older patients with hypercholesterolemia: a clinical review. JAMA 312:1136–1144PubMed

23.

Gnjidic D, Le Couteur DG, Blyth FM, Travison T, Rogers K, Naganathan V, Cumming RG, Waite L, Seibel MJ, Handelsman DJ, McLachlan AJ, Hilmer SN (2013) Statin use and clinical outcomes in older men: a prospective population-based study. BMJ Open 3:e002333. https://doi.org/10.1136/bmjopen-2012-002333 CrossRefPubMedPubMedCentral

24.

LaCroix AZ, Gray SL, Aragaki A, Cochrane BB, Newman AB, Kooperberg CL, Black H, Curb JD, Greenland P, Woods NF, Women’s Health Initiative (2008) Statin use and incident frailty in women aged 65 years or older: prospective findings from the Women’s Health Initiative Observational Study. J Gerontol A Biol Sci Med Sci 63:369–375PubMed

25.

Lee DS, Markwardt S, Goeres L, Lee CG, Eckstrom E, Williams C, Fu R, Orwoll E, Cawthon PM, Stefanick ML, Mackey D, Bauer DC, Nielson CM (2014) Statins and physical activity in older men. The Osteoporotic Fractures in Men Study. JAMA Intern Med 174:1263–1270PubMedPubMedCentral

26.

Gu SZ, Qiu W, Batty JA, Sinclair H, Veerasamy M, Brugaletta S, Neely D, Ford G, Calvert PA, Mintz GS, Kunadian V (2019) Coronary artery lesion phenotype in frail older patients with non-ST elevation acute coronary syndrome undergoing invasive care. EuroIntervention. https://doi.org/10.4244/EIJ-D-18-00848 CrossRefPubMed

27.

Hiro T, Kimura T, Morimoto T, Miyauchi K, Nakagawa Y, Yamagishi M, Ozaki Y, Kimura K, Saito S, Yamaguchi T, Daida H, Matsuzaki M (2009) Effect of intensive statin therapy on regression of coronary atherosclerosis in patients with acute coronary syndrome. A multicenter randomized trial evaluated by volumetric intravascular ultrasound using pitavastatin versus atorvastatin [JAPAN-ACS (Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome) Study] Clinical Trials. J Am Coll Cardiol 54:293–302PubMed

28.

Komukai K, Kubo T, Kitabata H, Matsuo Y, Ozaki Y, Takarada S, Okumoto Y, Shiono Y, Orii M, Shimamura K, Ueno S, Yamano T, Tanimoto T, Ino Y, Yamaguchi T, Kumiko H, Tanaka A, Imanishi T, Akagi H, Akasaka T (2014) Effect of atorvastatin therapy on fibrous cap thickness in coronary atherosclerotic plaque as assessed by optical coherence tomography: the EASY-FIT study. J Am Coll Cardiol 64:2207–2217PubMed

29.

Takano M, Mizuno K, Yokoyama S, Seimiya K, Ishibashi F, Okamatsu K, Uemura R (2003) Changes in coronary plaque color and morphology by lipid-lowering therapy with atorvastatin: serial evaluation by coronary angioscopy. J Am Coll Cardiol 42:680–686PubMed

30.

Hong YJ, Jeong MH, Choi YH, Ma EH, Ko JS, Lee MG, Park KH, Sim DS, Yoon NS, Youn HJ, Kim KH, Park HW, Kim JH, Ahn Y, Cho JG, Park JC, Mintz GS, Weissman NJ, Kang JC (2010) Effect of renal function on ultrasonic coronary plaque characteristics in patients with acute myocardial infarction. Am J Cardiol 105:936–942PubMed

31.

Wang ZJ, Zhou YJ, Galper BZ, Gao F, Yeh RW, Mauri L (2015) Association of body mass index with mortality and cardiovascular events for patients with coronary artery disease: a systematic review and meta-analysis. Heart 101:1631–1638PubMed

32.

Hyde Z, Flicker L, Almeida OP, Hankey GJ, McCaul KA, Chubb SAP, Yeap BB (2010) Low free testosterone predicts frailty in older men: the health in men study. J Clin Endocrinol Metab 95:3165–3172PubMed

33.

Corona G, Rastrelli G, Monami M, Guay A, Buvat J, Sforza A, Forti G, Mannucci E, Maggi M (2011) Hypogonadism as a risk factor for cardiovascular mortality in men: a meta-analytic study. Eur J Endocrinol 165:687–701PubMed

34.

Sanchis J, Bonanad C, Ruiz V, Fernández J, García-Blas S, Mainar L, Ventura S, Rodríguez-Borja E, Chorro FJ, Hermenegildo C, Bertomeu-González V, Núñez E, Núñez J (2014) Frailty and other geriatric conditions for risk stratification of older patients with acute coronary syndrome. Am Heart J 168:784–791PubMed

35.

Alonso Salinas GL, Sanmartin M, Pascual Izco M, Rincon LM, Pastor Pueyo P, Marco Del Castillo A, Garcia Guerrero A, Caravaca Perez P, Recio-Mayoral A, Camino A, Jimenez-Mena M, Zamorano JL (2017) Frailty is an independent prognostic marker in elderly patients with myocardial infarction. Clin Cardiol 40:925–931PubMedPubMedCentral

36.

Batty J, Qiu W, Gu S, Sinclair H, Veerasamy M, Beska B, Neely D, Ford G, Kunadian V, ICON-1 Study Investigators (2019) One-year clinical outcomes in older patients with non-ST elevation acute coronary syndrome undergoing coronary angiography: an analysis of the ICON1 study. Int J Cardiol 274:45–51PubMed

37.

Stone GW, Maehara A, Lansky AJ, de Bruyne B, Cristea E, Mintz GS, Mehran R, McPherson J, Farhat N, Marso SP, Parise H, Templin B, White R, Zhang Z, Serruys PW (2011) A prospective natural-history study of coronary atherosclerosis. N Engl J Med 364:226–235

38.

Arques S, Ambrosi P (2011) Human serum albumin in the clinical syndrome of heart failure. J Card Fail 17:451–458PubMed

39.

Horwich TB, Kalantar-Zadeh K, MacLellan RW, Fonarow GC (2008) Albumin levels predict survival in patients with systolic heart failure. Am Heart J 155:883–889PubMed

40.

Chen Y, Copeland WK, Vedanthan R, Grant E, Lee JE, Gu D, Gupta PC, Ramadas K, Inoue M, Tsugane S, Tamakoshi A, Gao YT, Yuan JM, Shu XO, Ozasa K, Tsuji I, Kakizaki M, Tanaka H, Nishino Y, Chen CJ, Wang R, Yoo KY, Ahn YO, Ahsan H, Pan WH, Chen CS, Pednekar MS, Sauvaget C, Sasazuki S, Yang G, Koh WP, Xiang YB, Ohishi W, Watanabe T, Sugawara Y, Matsuo K, You SL, Park SK, Kim DH, Parvez F, Chuang SY, Ge W, Rolland B, McLerran D, Sinha R, Thornquist M, Kang D, Feng Z, Boffetta P, Zheng W, He J, Potter JD (2013) Association between body mass index and cardiovascular disease mortality in east Asians and south Asians: pooled analysis of prospective data from the Asia Cohort Consortium. BMJ 347:f5446. https://doi.org/10.1136/bmj.f5446 CrossRefPubMedPubMedCentral

41.

Sasazuki S, Inoue M, Tsuji I, Sugawara Y, Tamakoshi A, Matsuo K, Wakai K, Nagata C, Tanaka K, Mizoue T, Tsugane S, Research Group for the Development, and Evaluation of Cancer Prevention Strategies in Japan (2011) Body mass index and mortality from all causes and major causes in Japanese: results of a pooled analysis of 7 large-scale cohort studies. J Epidemiol 21:417–430PubMedPubMedCentral

42.

Herrmann J, Gersh BJ, Goldfinger JZ, Witzenbichler B, Guagliumi G, Dudek D, Kornowski R, Brener SJ, Parise H, Fahy M, McAndrew TC, Stone GW, Mehran R (2014) Body mass index and acute and long-term outcomes after acute myocardial infarction (from the harmonizing outcomes with revascularization and stents in acute myocardial infarction trial). Am J Cardiol 114:9–16PubMed

43.

Kosuge M, Kimura K, Kojima S, Sakamoto T, Ishihara M, Asada Y, Tei C, Miyazaki S, Sonoda M, Tsuchihashi K, Yamagishi M, Shirai M, Hiraoka H, Honda T, Ogata Y, Ogawa H (2008) Impact of body mass index on in-hospital outcomes after percutaneous coronary intervention for ST segment elevation acute myocardial infarction. Circ J 72:521–525PubMed

44.

Ashar FN, Moes A, Moore AZ, Grove ML, Chaves PHM, Coresh J, Newman AB, Matteini AM, Bandeen-Roche K, Boerwinkle E, Walston JD, Arking DE (2015) Association of mitochondrial DNA levels with frailty and all-cause mortality. J Mol Med (Berl) 93:177–186

45.

Zaslavsky O, Cochrane BB, Thompson HJ, Woods NF, Herting JR, LaCroix A (2013) Frailty: a review of the first decade of research. Biol Res Nurs 15:422–432PubMed

46.

Cappola AR, Xue Q-L, Fried LP (2009) Multiple hormonal deficiencies in anabolic hormones are found in frail older women: the women’s health and aging studies. J Gerontol A Biol Sci Med Sci 64:243–248PubMed

47.

Ren J, Anversa P (2015) The insulin-like growth factor I system: Physiological and pathophysiological implication in cardiovascular diseases associated with metabolic syndrome. Biochem Pharmacol 93:409–417PubMed

48.

Tse G, Gong M, Nunez J, Sanchis J, Li G, Ali-Hasan-Al-Saegh S, Wong WT, Wong SH, Wu WKK, Bazoukis G, Yan GX, Lampropoulos K, Baranchuk AM, Tse LA, Xia Y, Liu T, Woo J, International Health Informatics Study (IHIS) Network (2017) Frailty and mortality outcomes after percutaneous coronary intervention: a systematic review and meta-analysis. J Am Med Dir Assoc 18:1097.e1–1097.e10

Titel: Frailty and coronary plaque characteristics on optical coherence tomography
verfasst von: Hideo Amano
Ryota Noike
Takayuki Yabe
Ippei Watanabe
Ryo Okubo
Masayuki Koizumi
Mikihito Toda
Takanori Ikeda
Publikationsdatum: 01.06.2020
Verlag: Springer Japan
Erschienen in: Heart and Vessels / Ausgabe 6/2020
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-019-01547-2

Neu im Fachgebiet Kardiologie

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Komplette Revaskularisation bei Infarkt: Neue Studie setzt ein Fragezeichen

24.04.2024 ACC 2024 Nachrichten

Eine FFR-gesteuerte komplette Revaskularisation war in einer Studie bei Patienten mit akutem Myokardinfarkt und koronarer Mehrgefäßerkrankung klinisch nicht wirksamer als eine alleinige Revaskularisation der Infarktarterie.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2020

First in human: the effects of biventricular pacing on cardiac output in severe pulmonary arterial hypertension

Successful catheter ablation of persistent atrial fibrillation is associated with improvement in functional tricuspid regurgitation and right heart reverse remodeling

Engineering of functional cardiac tubes by stepwise transplantation of cardiac cell sheets onto intestinal mesentery

Narrower QRS may be enough to respond to cardiac resynchronization therapy in lightweight patients