{"type":"trials","record":{"id":27716,"source_id":"clinicaltrials-gov","external_id":"NCT04488536","title":"Management and Outcomes of Patients Admitted to Coronary Care Units, Depending on Degree of Frailty and Comorbidities","brief_summary":"Background Patients less than 80 years of age, who suffer a myocardial infarction (MI) are usually (\\>90%) offered an early invasive strategy including coronary angiography possibly followed by intervention, preferably percutaneous coronary intervention (PCI). Among non ST-elevation myocardial infarction (NSTEMI) patients, 80 years of age or over, only approximately 40% receive an invasive approach in Sweden, since the majority are handled in a conservative way, i.e. with medical treatment only. Furthermore, as with pharmacological treatment, there is a large variation between Swedish counties regarding the choice of strategy for the treatment of elderly (80+) patients with NSTEMI with an even larger variation between acute hospitals ranging from 20% to 90 %. The Swedish national guidelines for heart disease have emphasized that the patient's biological age, i.e. the patient's biological status and expected length of life, is crucial for decision-making. The Clinical Frailty Scale (CFS) is a global clinical measure of biological age, mixing co-morbidity, disability and cognitive impairment. The investigators have previously reported the potential importance of frailty for short-term (1 month) and medium-term outcome (1 year) in a NSTEMI population. However, published data on the role of frailty´s prognostic value, its capacity to predict adverse effects including complications, and the potential to guide clinical decision-making for elderly patients with myocardial infarction are scarce. Similarly, there is a lack of knowledge of how different patterns of comorbidity burden might influence rational decision-making. Aims To explore the association between frailty and treatment patterns in cardiac care To study the association between outcomes and degree of frailty, with and without comprehensive adjustment for differences in baseline characteristics. To study how treatment benefits for patients admitted to coronary care units differ in patients depending on comorbidities and frailty. Hypothesis The investigators hypothesize that frailty is independently associated with worse outcomes, including mortality, readmissions and complications. Methods and material An observational, register based, multicentre study. Inclusion criteria: Patients consecutively included in the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) registry. Exclusion criteria: None. SWEDEHEART is a national quality registry collecting information on all patients hospitalized with MI or suspected MI. All 72 Swedish hospitals with acute coronary care contribute with data. Briefly, information is collected prospectively about individual patients' medical history, treatment before admission, management during hospital stay, treatment at discharge, and diagnoses. Approximately 20.000 patients diagnosed with MI are included in this register per year. From January 1st 2020 frailty (CFS)…","overall_status":"Active Not Recruiting","phases":[],"study_type":"OBSERVATIONAL","sponsor":"Linkoeping University","enrollment":10000,"countries":["Sweden"],"start_date":"2020-07-29","completion_date":"2027-03-31","last_update_date":"2026-08-31","source_url":"https://clinicaltrials.gov/study/NCT04488536","editorial_summary":"A registered study indexed because it matched monitored longevity research terms. Registry status: Active Not Recruiting. Registration does not establish safety or effectiveness.","first_seen_at":"2026-09-24T23:18:17.115647+00:00","last_seen_at":"2026-09-25T06:15:13.984+00:00","metadata":{"sex":"ALL","acronym":null,"age_range":null,"comparator":null,"organization":"Linkoeping University","interventions":["Clinical Frailty Scale"],"registry_source":"ClinicalTrials.gov","outcome_measures":["Mortality rate by 6 months after inclusion. — 6 months after inclusion","Mortality rates up to 36 months after inclusion. — 3-36 months after inclusion","Rates of readmissions and complications up to 36 months after inclusion. — 3-36 months after inclusion","Description of treatment patterns including medications and invasive strategies from admission to hospital (inclusion)…"],"design_description":null,"source_has_results":false},"controlled_terms":["Myocardial Infarction","Frailty","Clinical Frailty Scale"],"relevance_confidence":100,"source_quality_score":100,"freshness_score":100,"publication_state":"published","match_explanation":"Title contains controlled term: frailty.","quality_checked_at":"2026-09-25T06:15:15.562724+00:00","duplicate_cluster_key":"id:nct04488536","duplicate_of_id":null,"evidence_snapshot":{"status":"structured","version":1,"duration":"2020-07-29 to 2027-03-31","comparator":null,"confidence":"structured-source","population":"ALL","provenance":{"duration":"start_date and completion_date","comparator":"registry arm fields","population":"registry eligibility fields","intervention":"registry intervention fields","participants":"enrollment","study_design":"study_type and registry design fields","evidence_stage":"phases","reported_outcome":"not available","outcomes_measured":"registry outcome-measure fields"},"generated_at":"2026-09-25T06:15:13.988Z","intervention":["Clinical Frailty Scale"],"participants":10000,"study_design":"OBSERVATIONAL","subject_scope":"Human clinical study registration","evidence_stage":"Phase not reported","safety_context":"Eligibility, adverse-event details, and clinical decisions must be checked in the official registry and with qualified clinicians.","source_support":"Structured registry protocol metadata; no finding-level conclusion is generated.","main_limitation":"This is a study registration. No reusable structured result is available here, so it cannot show whether the intervention worked or was safe.","reported_outcome":null,"outcomes_measured":["Mortality rate by 6 months after inclusion. — 6 months after inclusion","Mortality rates up to 36 months after inclusion. — 3-36 months after inclusion","Rates of readmissions and complications up to 36 months after inclusion. — 3-36 months after inclusion","Description of treatment patterns including medications and invasive strategies from admission to hospital (inclusion)…"],"regulatory_context":"Trial registration is not regulatory approval and does not establish that an intervention is available."},"clinical_trial_topics":[{"topic_slug":"frailty","is_published":true,"match_reasons":["Title contains controlled term: frailty.","Abstract contains controlled term: frailty.","Source terminology contains: frailty.","Title supplies longevity context: frailty, frail.","Study type is explicitly identified as OBSERVATIONAL."],"matched_fields":["title","abstract","controlled terminology","title context","study type"],"relevance_score":100,"intelligence_topics":{"name":"Frailty","slug":"frailty"}}],"content_sources":{"name":"ClinicalTrials.gov","homepage_url":"https://clinicaltrials.gov/"}},"canonical_url":"https://www.immortal.life/trials/27716","automation_disclosure":"Generated automatically from cited source metadata. No scientist, clinician, researcher, editor, or human reviewer evaluates this publication before release."}