Intervention in Frailty Versus Usual Care in Frail Patients After an Acute Myocardial Infarction

NCT ID: NCT02715453

Last Updated: 2021-01-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-31

Study Completion Date

2020-02-29

Brief Summary

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Frailty has been associated to a worse outcome in acute coronary syndromes, but the best management of frail patients after an acute coronary syndrome remains unknown. The aim was to investigate the benefit of an intervention on frailty in frail patients after an acute myocardial infarction.

Patients survivors after an acute myocardial infarction (with and without ST-segment elevation), older than 70 years and with pre-frailty (1-2 points) or frailty (≥3 points) according to the Fried's scale measured 24 hours before hospital discharge, will be included. The participants will be randomized to 2 strategies: a) intervention on frailty in addition to the usual care by the cardiologist, and b) conventional strategy consisting only of the usual care by the cardiologist. A multidisciplinary team (physicians, nurses and physiotherapists and nutritionists) will carry out the intervention on frailty The study contemplates a 2-year inclusion period and a 3rd year for the follow-up of the last included patient. The main outcome will be the frailty status (Fried's scale) at 3 months and 1 year. The secondary endpoint will be the clinical events, both cardiovascular and not cardiovascular events, including recurrent events (cumulative events analysis), for the total follow up (3 years in the case of the first included patient). The hypothesis is that an intervention on frailty will improve frailty status and the clinical outcomes in frail patients after an acute myocardial infarction.

Detailed Description

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Conditions

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Fragility

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Intervention on frailty

Intervention on frailty in addition to the usual care by the cardiologist. A multidisciplinary team (physicians, nurses and physiotherapists and nutritionists) will carry out the intervention on frailty

Group Type EXPERIMENTAL

Intervention on frailty

Intervention Type OTHER

Multidisciplinary team (physicians, nurses, physiotherapists, and nutritionists):

* Nutritional evaluation and intervention after randomization and regularly during follow-up
* Physiotherapy sessions for 3 months after randomization and home exercise program for 1 year
* Psychiatrist or psychologist assistance for 1 year after discharge

Control

Conventional strategy consisting only of the usual care by the cardiologist

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Intervention on frailty

Multidisciplinary team (physicians, nurses, physiotherapists, and nutritionists):

* Nutritional evaluation and intervention after randomization and regularly during follow-up
* Physiotherapy sessions for 3 months after randomization and home exercise program for 1 year
* Psychiatrist or psychologist assistance for 1 year after discharge

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Admission for acute myocardial infarction and survivors in the hospitalization phase
* Age =\>70 years
* Prefrail or frail status (Fried scale =\>1 points)

Exclusion Criteria

* Cognitive impairment (Pfeiffer test)
* Severe concomitant disease that could hamper the participation in the study
* Patient refusal to participate
Minimum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Valencia

OTHER

Sponsor Role lead

Responsible Party

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Juan Sanchis

Prof

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Juan Sanchis

Valencia, , Spain

Site Status

Countries

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Spain

References

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Sanchis J, Nunez E, Ruiz V, Bonanad C, Fernandez J, Cauli O, Garcia-Blas S, Mainar L, Valero E, Rodriguez-Borja E, Chorro FJ, Hermenegildo C, Nunez J. Usefulness of Clinical Data and Biomarkers for the Identification of Frailty After Acute Coronary Syndromes. Can J Cardiol. 2015 Dec;31(12):1462-8. doi: 10.1016/j.cjca.2015.07.737. Epub 2015 Aug 21.

Reference Type BACKGROUND
PMID: 26514748 (View on PubMed)

Sanchis J, Bonanad C, Ruiz V, Fernandez J, Garcia-Blas S, Mainar L, Ventura S, Rodriguez-Borja E, Chorro FJ, Hermenegildo C, Bertomeu-Gonzalez V, Nunez E, Nunez J. Frailty and other geriatric conditions for risk stratification of older patients with acute coronary syndrome. Am Heart J. 2014 Nov;168(5):784-91. doi: 10.1016/j.ahj.2014.07.022. Epub 2014 Jul 30.

Reference Type BACKGROUND
PMID: 25440808 (View on PubMed)

Sanchis J, Sastre C, Ruescas A, Ruiz V, Valero E, Bonanad C, Garcia-Blas S, Fernandez-Cisnal A, Gonzalez J, Minana G, Nunez J. Randomized Comparison of Exercise Intervention Versus Usual Care in Older Adult Patients with Frailty After Acute Myocardial Infarction. Am J Med. 2021 Mar;134(3):383-390.e2. doi: 10.1016/j.amjmed.2020.09.019. Epub 2020 Oct 24.

Reference Type DERIVED
PMID: 33228950 (View on PubMed)

Other Identifiers

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15/00837

Identifier Type: -

Identifier Source: org_study_id

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