Abstract 14045: Frailty as Assessed by Gait Speed is Associated With Peripheral Endothelial Dysfunction in Older Patients With ST-segment Elevation Myocardial Infarction
Introduction: Endothelial dysfunction plays a pivotal role in the progression of atherosclerosis and subsequent cardiovascular events. In older patients, decreased gait speed is associated with worse cardiovascular outcomes. However, the association with endothelial dysfunction and gait speed in older patients with ST-segment elevation myocardial infarction (STEMI) remains unclear.
Hypothesis: We assessed the hypothesis that slow gait speed is associated with peripheral endothelial dysfunction in older patients with STEMI.
Methods: A total of 353 patients with STEMI were enrolled and divided into younger (age < 65 years) and older (age ≥ 65 years) groups. We assessed peripheral endothelial function by reactive hyperemia peripheral arterial tonometry (RH-PAT) as RH-PAT index (RHI), and we defined endothelial dysfunction as RHI≤1.67. Gait speeds were measured by using a 200-m course before discharge.
Results: The prevalence of endothelial dysfunction was significantly higher in older patients than in younger patients (n=85 (48.9%) versus n=51 (28.5%), p<0.001). By the univariate logistic regression analysis, the associated factors of endothelial dysfunction were diabetes (odds ratio: 2.19, 95% confidence interval: 1.12 to 4.27, p=0.022) in younger patients whereas slow gait speed (odds ratio for 0.1m/s increase in gait speed: 0.77, 95% confidence interval: 0.63 to 0.94, p=0.009) in older patients (Table). In older patients, the multivariate logistic regression analysis including age, gender and various classical risk factors demonstrated that only gait speed significantly and independently correlated with low RHI (odds ratio for 0.1m/s increase in gait speed: 0.80, 95% confidence interval: 0.65 to 0.99, p=0.043).
Conclusions: Slow gait speed was independently related with peripheral endothelial dysfunction in older patients with STEMI. Frailty could play a crucial role in the pathogenesis of atherosclerosis in older patients with STEMI.
Author Disclosures: R. Satou: None. Y. Matsuzawa: None. E. Akiyama: None. H. Suzuki: None. C. Kawashima: None. M. Konishi: None. K. Hashiba: None. N. Maejima: None. N. Iwahashi: None. K. Hibi: Research Grant; Modest; AstraZeneca Co., Ltd, MSD Co., Ltd, Solve Co., Ltd, Biosensors Japan Co., Ltd, Teijin Pharma Co., Ltd, Terumo Co., Ltd, Mochida Pharmaceutical Co., Ltd. Research Grant; Significant; Goodman Co., Ltd, Medtronic Japan Co., Ltd, St. Jude Medical Japan Co., Ltd. Honoraria; Modest; Daiichi-Sankyo Co., Ltd, Boston Scientific Japan Co., Ltd. Consultant/Advisory Board; Modest; Terumo Co., Ltd, St. Jude Medical Japan Co., Ltd. M. Kosuge: None. T. Ebina: None. S. Sumita: None. K. Kimura: Research Grant; Significant; Toa Eiyo Ltd, Bayer, MSD, Astellas, Astrazeneca, Sanofi, Eli Lilly Japan, Research Institute for Production Development, Pfizer, Shionogi, Kowa-souyaku, Daiichi-Sankyo, Mitsubishi Tanabe, Nihon-Boehringer-Ingelheim, Takeda, Otsuka, Ono. Honoraria; Modest; Astrazeneca, Toa Eiyo Ltd. Honoraria; Significant; MSD, Bayer, Daiichi-Sankyo. Y. Kimura: None.
- © 2016 by American Heart Association, Inc.