(NVKP-16-1-2016-0017 National Heart Program) Támogató: NKFIH
Frailty is a complex clinical syndrome associated with aging and comorbidities, which
correlates with unfavorable outcomes. However, in heart failure patients, frailty
is very common, data is scarce about those, who are eligible for Cardiac Resynchronization
Therapy (CRT) implantation. We investigated the incidence of frailty and the association
of Frailty Index (FI) with the outcome. Thirty baseline clinical parameters were used
by the Rockwood cumulative deficit method to determine patients' FI in our single-center
cohort. Based on previous studies, patients with FI ≤ 0.210 were considered as non-frail,
those with FI 0.10–0.210 were classified in Frail-1, with FI > 0.10 in Frail-2 groups,
respectively. Echocardiographic response after 12 months and all-cause mortality were
investigated by frailty groups. Among 1004 included patients, 75 (7%) were considered
Non-frail, 271 (27%) grouped in Frail-1, and 658 (66%) in Frail-2 with a median FI
of 0.36 (0.28–0.43). Patients in Frail-2 group were older, with more comorbidities
compared with non-frail patients or those in Group Frail-1. During the median follow-up
time of 4.8 years, 29 (39%) patients died in the Non-frail, 140 (52%) in Frail-1,
and 471 (72%) in the Frail-2 groups (log-rank p < 0.001). Group Frail-2 showed an
unfavorable outcome compared to the non-frail (HR 2.49, 95%CI 1.92–3.22; p < 0.001)
and the Frail-1 group (1.83, 95%CI 1.55–2.16; p < 0.001). In our HFrEF patients eligible
for CRT implantation, patients were exceedingly vulnerable with a high prevalence
of frailty. The calculated frailty index was associated with outcome and proved to
be prevalent in individual risk stratification.
