Abstract 4373582: Phenotypic Age Predicts Long-Term Cardiac Outcomes Better Than Chronological Age in Patients with Acute Myocardial Infarction

Background: Phenotypic Age (PhenoAge), which is calculated based on chronological age and nine biomarkers, has been shown to better predict in-hospital outcomes in patients with acute myocardial infarction (AMI). Research Question: This study aimed to determine whether PhenoAge predicts long-term cardiac outcomes in AMI patients more accurately than chronological age. Methods: In this retrospective study, we included 5,440 patients who underwent percutaneous coronary intervention (PCI) for AMI at a tertiary hospital between December 2009 and November 2018. Clinical outcomes included cardiac death (defined as death due to heart failure, myocardial infarction, or arrhythmia) and all-cause death. Results: The mean PhenoAge and chronological age of the entire patient cohort were 66.24 ± 11.77 years and 78.55 ± 19.07 years, respectively. During a follow-up period of 51.03 ± 36.97 months, there were 331 cases of cardiac death and 570 cases of all-cause death. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve for predicting cardiac death was higher for PhenoAge (AUC: 0.746, p < 0.01) than for chronological age (AUC: 0.638, p < 0.01). Similarly, for all-cause death, PhenoAge (AUC: 0.719, p < 0.01) outperformed chronological age (AUC: 0.649, p < 0.01). However, both PhenoAge (AUC: 0.436, p < 0.01) and chronological age (AUC: 0.455, p < 0.01) showed low predictive power for revascularization. Patients with PhenoAge ≥80 had a higher risk of cardiac death than those with PhenoAge <80 [hazard ratio (HR) 5.12; 95% confidence interval (CI) 3.97–6.59; p < 0.01], and this risk was greater than that observed in patients with chronological age ≥80 compared to those <80 (HR 3.39; CI 2.66–4.34; p < 0.01). Conclusion: PhenoAge more accurately predicts long-term outcomes, including cardiac death, than chronological age in AMI patients who underwent PCI. The risk of cardiac death in patients with PhenoAge ≥80 is higher than in those with PhenoAge <80 and exceeds the corresponding risk difference observed using chronological age.