Angina Pectoris Severity Among Patients with Pre-Existing Cardiovascular Disease is Associated with Subsequent Frailty in Late Life

Background: Frailty is a geriatric syndrome of increased vulnerability to stressors more common in patients with cardiovascular disease (CVD). We investigated the association between severity of angina pectoris (AP) and subsequent late-life frailty among men with CVD.

Methods: A subset of 351 men (mean age at baseline 56.7±6.5 years), participants in the Bezafibrate Infarction Prevention (BIP) trial (1990-1997) who continued in the BIP Neurocognitive study underwent a neurovascular evaluation 14.6±1.9 years (T1) after baseline and were evaluated for frailty 19.9±1.0 years (T2) after baseline. Severity of AP was assessed at baseline using the Canadian Cardiovascular Society angina classification. Frailty status was measured at T2 according to the phenotype developed by Fried and categorized into robust, pre-frail and frail. We assessed the change in the odds of being in the advanced rank of frailty status (robust, pre-frail and frail) using ordered logistic regression in men with AP class ≥2 compared to those with AP<2.

Results: Among 351 patients, 117 (33.3%) were classified as robust, 134 (38.2%) as pre-frail and 100 (28.5%) as frail. Frailty was found among 42.0% patients at the AP class≥2 and among 26.2% patients at the AP class

Conclusion: Among men with CVD, severity of AP might play an important predictive role due to its association with increased risk of late-life frailty.

Key words: Angina pectoris; Cardiovascular disease; Elderly; Frailty