Effect of frailty on major bleeding in octogenarian patients undergoing percutaneous coronary intervention

OBJECTIVE: There has been an increase in the number of percutaneous coro-nary intervention (PCI) procedures performed in octogenarian patients due to increased life expectancy and developments in modern med-icine. Frailty is associated with the aging pro-cess, gradual loss of multiple body functions, and poor health outcomes. We examined the association between frailty and major bleeding in octogenarian patients undergoing PCI.PATIENTS AND METHODS: We retrospec-tively analyzed the records of two local re-search hospitals in Turkey. In total, 244 patients were enrolled in this study. Patients were divid-ed into two groups based on their Clinical Frail-ty Scale (CFS) score. The non-frail group in-cluded patients with CFS scores of 1 (very fit) to 4 (living with very mild frailty), while the frail group included those with CFS scores of 5 (liv-ing with mild frailty) to 9 (terminally ill).RESULTS: Of the 244 patients, 131 were classified into the non-frail group and 113 in-to the frail group. Ticagrelor use was signifi-cantly more common in the non-frail group (31.3% vs. 20.4%, p=0.036). Major bleeding was more common in the frail than non-frail group (20.4% vs. 6.1%, p<0.001). The rates of stroke and all-cause death were higher in the frail than in non-frail group (stroke 15.9% vs. 3.8%, p<0.001, as well as all-cause mortality rate (27.4% vs. 2.3%, p<0.001).CONCLUSIONS: Frailty is an independent predictor of major bleeding in patients under-going PCI for acute coronary syndrome. Use of the P2Y12 inhibitor ticagrelor increases the risk of major bleeding in frail patients.