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The prognostic significance of frailty compared to peak oxygen consumption and B‐type natriuretic peptide in patients with advanced heart failure
Author(s) -
Moayedi Yasbanoo,
Duero Posada Juan G.,
Foroutan Farid,
Goldraich Livia A.,
Alba Ana C.,
MacIver Jane,
Ross Heather J.
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13158
Subject(s) - medicine , natriuretic peptide , heart failure , cardiology , heart transplantation , brain natriuretic peptide , clinical significance
Frailty assessment has become an integral part of the evaluation of potential candidates for heart transplantation and ventricular assist device ( HT x/ VAD ). The impact of frailty, as a heart failure risk factor or to identify those who will derive the greatest benefit with HT x/ VAD remains unclear. The aim of this study was to evaluate the independent prognostic relevance of frailty assessment from peak oxygen consumption (peak VO 2 ) or B‐type natriuretic peptide ( BNP ) on mortality in patients referred for advanced heart failure therapies. Frailty was measured using modified Fried frailty criteria. In 201 consecutive patients, during a median follow‐up of 17.5 months ( IQR 11‐29.2), there were 25 (12.4%) deaths. One‐year survival was 100%, 94%, and 78% in nonfrail, prefrail, and frail patients, respectively (log rank P = .0001). Frailty was associated with a twofold increase risk of death ( HR 2.01, P < .0001, 95% CI 1.42‐2.84). When adjusted for BNP or peak VO 2 , frailty was not associated with a significant risk of all‐cause death. However, when peak VO 2 is stratified into two categories (≥12 mL/kg/min vs <12 mL/kg/min), frailty was associated with increased mortality in patients with a lower peak VO 2 ( HR 1.72, P = .006).