Physical frailty Is Associated with Increased Risk of Adverse Clinical Outcomes in Patients with Stable Coronary Artery Disease

Abstract Objectives: The prognostic value of each physical frailty and its components on adverse clinical outcomes, particularly for the population with stable coronary artery disease (SCAD), is still not well studied. This study aims to investigate the prevalence of physical frailty in the older adults with SCAD in community-dwelling setting and examine the influence of physical frailty and its different domains to the risk of adverse clinical outcomes among elders with SCAD. Design: Register-based retrospective longitudinal study. Setting and participants: The study cohort included a total of 221 patients aged 65 years or older who were diagnosed with SCAD and continuously sought care at the Geriatrics and Cardiology Outpatient Department of PLA General Hospital between July 15, 2015, and June 30, 2016. Methods: After enrollment, the patients were divided into three groups according to the Fried phenotype. Health outcomes, including all-cause mortality and hospitalization, were assessed and verified by phone calls and electronic medical records (EMR) every 24 months, with a total of 2 review times per patient. The association between all-cause mortality and each of the five domains of the Fried phenotype were assessed using Cox model. Three models with progressive adjustment for potential confounders were fitted. Results: After adjusting for potential confounders, physical frailtywas independently associated with all-cause mortality (frail group: aHR: 4.80; 95% CI 1.71–13.45; P = 0.003) compared to non-physical frailty. Slow gait speed (aHR: 6.75; 95% CI: 1.63 to 27.91; p =0.008) was significantly associated with the all-cause mortality, while weak grip strength was significantly associated with hospitalization (aHR:2.04; 95% CI:1.23 to 3.39; p = 0.006). Conclusions and Implications: Physical frailty in general and different physical frailtydomains in particular are independently associated increased mortality among SCAD patients. Slow gait speed and weak grip strength maybe potentially increase future hospitalization and death. physical frailty and its domains especially gait speed and grip strength should be screened early in SCAD patients to reduce mortality. Novelty： It is the first time investigating the the influence of physical frailty on the prognosis among the older adults with SCAD in Chinese community-dwelling setting and examine the influence of different physical frailty domains to the risk of adverse clinical outcomes among elders with SCAD.