BACKGROUND The potential sex-differential effect of frailty in patients with acute coronary syndromes (ACS) has not been well-evaluated. We sought to examine the sex-differential association between frailty status on long-term mortality in elderly patients with an ACS. METHODS AND RESULTS This is a prospective observational single-center study that included 488 elderly patients (>65 years) hospitalized for ACS who survived the index hospitalization. Multivariate Cox regression was used to determine the association among the exposures (interaction of sex with Fried score and sex with Fried ≥ 3) and all-cause mortality. The mean age of the sample was 78 ± 7 years; 41% were female and the median Fried score was higher in women [3 (2-3) vs. 2 (1-2) points, p < 0.001]. At a median follow-up of 3.12 years (IQR:1.38-5.13), 182 deaths (37.3%) were registered. The association of Fried ≥ 3 with mortality varied across sex (p-value for interaction = 0.022). In males, Fried ≥ 3 was independently associated with all-cause death (HR = 1.89; CI 95%:1.25-2.85, p = 0.003). However, it showed a neutral effect on women (HR = 0.92; CI 95%:0.57-1.49, p = 0.726). CONCLUSIONS In this work, we found that the frailty status assessed by Fried score was independently associated with mortality in elderly males but not in females with ACS.

中文翻译：

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衰弱对老年急性冠脉综合征患者长期死亡率的性别差异影响。

背景技术在急性冠状动脉综合征（ACS）患者中，身体虚弱的潜在性别差异效应尚未得到很好的评估。我们试图检查老年患者ACS的虚弱状态与长期死亡率之间的性别差异。方法和结果这是一项前瞻性观察性单中心研究，其中包括488名在ACS住院治疗中幸存的ACS老年患者（> 65岁）。多因素Cox回归用于确定暴露（性别与Fried分数的交互作用和性别与Fried≥3的交互作用）与全因死亡率之间的关联。样本的平均年龄为78±7岁；女性为41％，女性的平均Fried评分更高[3（2-3）vs. 2（1-2）点，p <0.001]。中位随访时间为3.12年（IQR：1.38-5.13），有182例死亡（37。3％）已注册。Fried≥3与死亡率的关联因性别而异（相互作用的p值= 0.022）。在男性中，Fried≥3与全因死亡独立相关（HR = 1.89； CI 95％：1.25-2.85，p = 0.003）。然而，它对女性表现出中性作用（HR = 0.92； CI 95％：0.57-1.49，p = 0.726）。结论在这项工作中，我们发现，以Fried评分评估的虚弱状态与ACS老年男性的死亡率独立相关，而与女性无关。