Evidence map›Paper›PMID 37639487›Full record

ArticleEuropean heart journal2023

Frailty and outcomes in heart failure patients from high-, middle-, and low-income countries.

Darryl P Leong, Philip Joseph, John J V McMurray, Jean Rouleau, Aldo P Maggioni, Fernando Lanas, Sanjib K Sharma, Julio Núñez, Bishav Mohan, Ahmet Celik and 7 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European heart journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 2 pooled it
7.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.

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  18. Accelerated aging and frailty in cardiovascular diseases.Journal of geriatric cardiology : JGC · 2024
    Article
  19. Review
  20. The Dual Burden of Frailty and Heart Failure.International journal of heart failure · 2024
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 12 institutions in 9 countries.

Darryl P LeongThe Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton General Hospital, C2-238 David Braley Building, 237 Barton St. East, Hamilton, ON L8L 2X2, Canada.ORCID 0000-0002-1968-169X
Philip JosephThe Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton General Hospital, C2-238 David Braley Building, 237 Barton St. East, Hamilton, ON L8L 2X2, Canada.
John J V McMurrayBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.
Jean RouleauDepartment of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montréal, QC H3T 1J4, Canada.
Aldo P MaggioniANMCO Research Center, Heart Care Foundation, Via La Marmora, 36 - 50121 Firenze, Italy.
Fernando LanasDepartment of Internal Medicine, Universidad de La Frontera, Temuco 4780000, Chile.ORCID 0000-0003-3595-9759
Sanjib K SharmaB.P. Koirala Institute of Health Sciences, Buddha Road, Dharan 56700, Nepal.ORCID 0000-0002-8392-8028
Julio NúñezServicio de Cardiología, Hospital Clínico Universitario Valencia, Avda. Blasco Ibáñez 17, 46010 Valencia, Spain.ORCID 0000-0003-1672-7119
Bishav MohanDayanand Medical College and Hospital, Civil Lines, Tagore Nagar, Ludhiana 141001, India.
Ahmet CelikFaculty of Medicine, Mersin University, 31168 Sokak, Ritim Ofis, A Blok 1 Kat, 33000 Mersin, Türkiye.
Jabir AbdullakuttyLisie Hospital, Cochin 682018, Kerala, India.
Okechukwu S OgahDepartment of Medicine, University of Ibadan and University College Hospital Ibadan, PO Box 14343, Ibadan, Nigeria.
Lisa M MielniczukUniversity of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada.
Kumar BalasubramanianThe Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton General Hospital, C2-238 David Braley Building, 237 Barton St. East, Hamilton, ON L8L 2X2, Canada.
Tara McCreadyThe Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton General Hospital, C2-238 David Braley Building, 237 Barton St. East, Hamilton, ON L8L 2X2, Canada.
Alex GrinvaldsThe Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton General Hospital, C2-238 David Braley Building, 237 Barton St. East, Hamilton, ON L8L 2X2, Canada.
Salim YusufThe Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton General Hospital, C2-238 David Braley Building, 237 Barton St. East, Hamilton, ON L8L 2X2, Canada.
Hamilton General Hospital · CAAssociazione Nazionale Medici Cardiologi Ospedalieri · ITB.P. Koirala Institute of Health Sciences · NPBritish Heart Foundation · GBDayanand Medical College & Hospital · INHospital Clínico Universitario de Valencia · ESLourdes Hospital · INMersin Üniversitesi · TRUniversidad de La Frontera · CLUniversité de Montréal · CAUniversity of Ibadan · NGUniversity of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsThere is little information on the incremental prognostic importance of frailty beyond conventional prognostic variables in heart failure (HF) populations from different country income levels.

methodsA total of 3429 adults with HF (age 61 ± 14 years, 33% women) from 27 high-, middle- and low-income countries were prospectively studied. Baseline frailty was evaluated by the Fried index, incorporating handgrip strength, gait speed, physical activity, unintended weight loss, and self-reported exhaustion. Mean left ventricular ejection fraction was 39 ± 14% and 26% had New York Heart Association Class III/IV symptoms. Participants were followed for a median (25th to 75th percentile) of 3.1 (2.0-4.3) years. Cox proportional hazard models for death and HF hospitalization adjusted for country income level; age; sex; education; HF aetiology; left ventricular ejection fraction; diabetes; tobacco and alcohol use; New York Heart Association functional class; HF medication use; blood pressure; and haemoglobin, sodium, and creatinine concentrations were performed. The incremental discriminatory value of frailty over and above the MAGGIC risk score was evaluated by the area under the receiver-operating characteristic curve.

resultsAt baseline, 18% of participants were robust, 61% pre-frail, and 21% frail. During follow-up, 565 (16%) participants died and 471 (14%) were hospitalized for HF. Respective adjusted hazard ratios (95% confidence interval) for death among the pre-frail and frail were 1.59 (1.12-2.26) and 2.92 (1.99-4.27). Respective adjusted hazard ratios (95% confidence interval) for HF hospitalization were 1.32 (0.93-1.87) and 1.97 (1.33-2.91). Findings were consistent among different country income levels and by most subgroups. Adding frailty to the MAGGIC risk score improved the discrimination of future death and HF hospitalization.

conclusionsFrailty confers substantial incremental prognostic information to prognostic variables for predicting death and HF hospitalization. The relationship between frailty and these outcomes is consistent across countries at all income levels.

Indexed as

FrailtyHeart FailureAgedFemaleHand StrengthHumansMaleMiddle AgedStroke VolumeVentricular Function, LeftCohortFrailtyGlobal healthHeart failureRisk score

Identifiers

PMID37639487
PMCPMC10635666
OpenAlexW4386212890

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.