Clinical and Biological Markers of Frailty Syndrome in Patients Undergoing Elective Percutaneous Coronary Intervention

择期经皮冠状动脉介入治疗患者虚弱综合征的临床和生物学标志物

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Abstract

BACKGROUND: The aim of this study was to analyze the prevalence of prefrailty and frailty syndrome (FS) in patients with coronary artery disease (CAD), and the clinical and biological characteristics of frail patients undergoing elective percutaneous coronary intervention (PCI). MATERIAL AND METHODS: The study included 78 patients with CAD who were admitted to the clinic to undergo PCI. To detect prefrailty and FS in patients, we used a short physical performance test battery (10-12 points-no FS, 8-9 points-prefrailty, 7 or fewer points-FS). We used the RayBio(®) Human ELISA Kit (Norcross, GA, USA), a highly sensitive and highly specific enzyme-linked immunosorbent assay, to determine the concentration of biological markers of inflammation (IL-6, IL-10, IL-13, IL-15, TNF-α) and bone, muscle, and fat remodeling (leptin, calcitonin, osteoprotegerin, osteocalcin, myostatin) in the serum of patients with coronary artery disease before planned PCI. RESULTS: Taking into account the test battery score, the prevalence of FS in patients with CAD before elective PCI was 24.4%, the prevalence of prefrailty was 33.3%. According to the results of the study, older women with type 2 diabetes in their history were significantly more likely to be frail. Studying a wide range of biological markers of inflammation and musculoskeletal and fat remodeling, we noted lower levels of calcitonin (2.60 [1.50; 5.85] pg/mL, p = 0.018) and osteoprotegerin (0.80 [0.60; 1.20] ng/mL, p = 0.025) in the serum of frail patients with CAD. Later we confirmed the results by correlation analysis. Moreover, we found an association between FS and higher serum leptin levels in patients with CAD before elective PCI. CONCLUSION: The results of the study confirm the high prevalence of prefrailty (33.3%) and FS (24.4%) in patients with CAD. Older women with type 2 diabetes in their history were significantly more likely to be frail. At the same time, the presence of FS is associated with lower levels of calcitonin and osteoprotegerin, and higher levels of leptin in the serum of frail patients before elective PCI.

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