Frailty in Elderly Patients with Acute Coronary Syndrome in India

Background: Association of frailty in Indian elderly patients with acute coronary syndrome (ACS) has not been investigated. Our objective was to estimate the prevalence of frailty due to the severity of ACS in elderly patients in India. The study also aimed to find out the association between the number of health deficits with ACS severity among elderly patients and to explore the association of frailty with conventional risk factors for coronary artery disease among the patients. Materials and Methods: A cross-sectional study was performed for a period of 18 months where 100 elderly patients >= 60 years age, having ACS, regardless of gender, were recruited from the Department of Medicine, Guru Teg Bahadur Hospital, Delhi. Frailty was assessed with the help of Fried index along with a number of deficits in health. Assessment of ACS was done on the basis of the ECHO findings that took into account the left ventricular ejection fraction. Results: The occurrence of frailty was 44% among elderly patients presenting with ACS. The association between the number of health deficits with the severity of ACS at presentation among elderly patients was found to be statistically significant (P < 0.001), with ACS severity increases as health deficit increases. No significant association was observed on co-relating each conventional factor with frailty, while a strong association between depression and frailty was observed (P < 0.001). Conclusion: This study concludes that in Indian elderly patients, there is an important association between frailty and ACS in terms of incidence, diagnosis, and prognosis.