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Viewpoint on “The Frail Scale – A Risk Stratification in Older Patients with Acute Coronary Syndrome” [Response to Letter]
Authors Pham HM, Nguyen AP , Nguyen HTT , Nguyen TN, Nguyen TX , Nguyen TTH , Nguyen HTT, Nguyen AT , Nguyen QN , Tran GS , Vu HTT
Received 24 July 2023
Accepted for publication 8 August 2023
Published 28 August 2023 Volume 2023:16 Pages 2527—2528
Hung Manh Pham,1,2 Anh Phuong Nguyen,1,2 Huong Thi Thu Nguyen,3,4 Tam Ngoc Nguyen,3,4 Thanh Xuan Nguyen,3,4 Thu Thi Hoai Nguyen,3,4 Huong Thi Thanh Nguyen,5,6 Anh Trung Nguyen,3,4 Quang Ngoc Nguyen,1,2 Giang Song Tran,1 Huyen Thi Thanh Vu3,4
1Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, 100000, Vietnam; 2Department of Cardiology, Hanoi Medical University, Hanoi, 100000, Vietnam; 3Department of Geriatrics, Hanoi Medical University, Hanoi, 100000, Vietnam; 4Scientific Research Department, National Geriatric Hospital, Hanoi, 100000, Vietnam; 5Physiology Department, Hanoi Medical University, Hanoi, 100000, Vietnam; 6Dinh Tien Hoang Institute of Medicine, Hanoi, 100000, Vietnam
Correspondence: Anh Phuong Nguyen, Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, 100000, Vietnam, Tel +84 989314464, Email [email protected]
View the original paper by Dr Pham and colleagues
This is in response to the Letter to the Editor
Dear editor
We would like to thank doctor Xinyue Li for comments on our paper and the Editor for the opportunity to respond.1,2 Here is point-by-point response to the author’s comments and concerns.
Firstly, we discuss issues related to renal disease and frailty in elderly patients with acute coronary syndromes. As mentioned by the author, there is an association between patients with kidney disease and frailty in the elderly, not in the group of patients with acute coronary syndrome. Based on studies in the literature, we also find that chronic kidney disease (CKD) and acute kidney injury (AKI) in elderly patients with acute coronary syndromes are truly interesting.3,4 However, this issue is not within the scope of our research, especially during the COVID pandemic, when testing conditions are limited. Therefore, we save this issue for the following studies. Secondly, the category of BMI in Table 1, the proportion of obese patients is too low 1/116 (0.86%), so we do not analyze it separately, but group it together with the overweight group. Thirdly, in-hospital adverse outcome is composite event, so it includes major bleeding and stroke events in the NACE.
About some statistical analysis, firstly, in Table 3, we agree that presenting the reference set as 1 as suggested would be clearer and more accessible. Secondly, the regression analysis presented in Table 4, as the number of variables included increased, the OR values increased. In statistics, when increasing the number of variables in a multivariable logistic regression analysis, the OR can increase or decrease, depending on the relationship and impact between the variables. So, our results are really appropriate because these results further show the truly relationship between frailty and NACE after adjusting for the impact of related factors.
In conclusion, we greatly appreciate the author’s comments and suggestions. We fully agree with author about the potential role of the simple FRAIL score in risk stratification for older patients with ACS in the coronary care setting and that it is important to consider the need for evidence and extensive experience among different populations because the incidence of these different patients.
Disclosure
The authors report no conflicts of interest in this communication.
References
1. Xinyue L. Viewpoint on “The frail scale – a risk stratification in older patients with acute coronary syndrome”. J Multidiscip Healthc. 2023;16:1937–1938. doi:10.2147/JMDH.S429655
2. Pham HM, Nguyen AP, Nguyen HTT, et al. The frail scale - a risk stratification in older patients with acute coronary syndrome. J Multidiscip Health c. 2023;16:1521–1529. doi:10.2147/JMDH.S409535
3. Hashimoto Y, Ozaki Y, Kan S, et al.; J-MINUET Investigators. Impact of chronic kidney disease on in-hospital and 3-year clinical outcomes in patients with acute myocardial infarction treated by contemporary percutaneous coronary intervention and optimal medical therapy- insights from the J-MINUET Study. Circ J. 2021;85(10):1710–1718. doi:10.1253/circj.CJ-20-1115
4. Chalikias G, Serif L, Kikas P, et al. Long-term impact of acute kidney injury on prognosis in patients with acute myocardial infarction. Int J Cardiol. 2019;283:48–54. doi:10.1016/j.ijcard.2019.01.070
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