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

January 20, 2021 updated by: Juan Sanchis, University of Valencia

Randomized Comparison Between a Strategy of Intervention in Frailty Versus the Usual Care in Frail Patients After an Acute Myocardial Infarction

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

150

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Spain
      • Valencia, Spain, 46010
        • Juan Sanchis

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

70 years and older (Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: 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
Other: 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
No Intervention: Control
Conventional strategy consisting only of the usual care by the cardiologist

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change on frailty status according to the Fried scale
Time Frame: 3 months and 1 year
Points in the Fried scale
3 months and 1 year

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total cardiac (cardiac death, reinfarction, postdischarge revascularization, readmission for acute heart failure, readmission for other cardiac cause) and non-cardiac (all-cause mortality or readmission for non-cardiac cause) clinical events
Time Frame: Up to 3 years
Number of participants with the events
Up to 3 years
All-cause mortality
Time Frame: Up to 3 years
Number of participants dead
Up to 3 years
Ischemic events (reinfarction or postdischarge revascularization)
Time Frame: Up to 3 years
Number of participants with reinfarction (readmission for chest pain with troponin elevation) or postdischarge revascularization (percutaneous coronary intervention or coronary surgery)
Up to 3 years
Readmission for acute heart failure
Time Frame: Up to 3 years
Number of participants with readmission for acute heart failure
Up to 3 years
Readmission for non-cardiac causes
Time Frame: Up to 3 years
Number of participants with readmission for non-cardiac cause
Up to 3 years
Change of Quality of life (EUROQOL)
Time Frame: 3 months and 1 year
EUROQOL test
3 months and 1 year
Change of Functional capacity (walk distance test)
Time Frame: 3 months and 1 year
Distance walked during 6 minutes
3 months and 1 year
Change of Nutritional status (Mini Nutritional Assessment)
Time Frame: 3 months and 1 year
Mini Nutritional Assessment Test
3 months and 1 year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Valencia

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

January 1, 2016

Primary Completion (Actual)

August 1, 2019

Study Completion (Actual)

February 1, 2020

Study Registration Dates

First Submitted

March 4, 2016

First Submitted That Met QC Criteria

March 16, 2016

First Posted (Estimate)

March 22, 2016

Study Record Updates

Last Update Posted (Actual)

January 22, 2021

Last Update Submitted That Met QC Criteria

January 20, 2021

Last Verified

January 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 15/00837

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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