Why the study?
CAD management remains challenging in older adults due to frailty and comorbidities, yet frail older adults remain underrepresented in the literature.
Assessing frailty is crucial for tailoring coronary artery disease management in older adults, who are often underrepresented in clinical trials.
Frailty assessment may aid CAD decisions in older adults; leaves open optimal strategies due to trial underrepresentation.
Coronary artery disease (CAD) is highly prevalent in older adults, yet its management remains challenging. Treatment choices are made complex by the frailty burden of older patients, a high prevalence of comorbidities and body composition abnormalities (e.g., sarcopenia), the complexity of coronary anatomy, and the frequent presence of multivessel disease, as well as the coexistence of major ischemic and bleeding risk factors. Recent randomized clinical trials and epidemiological studies have provided new data on optimal management of complex patients with CAD. However, frail older adults are still underrepresented in the literature. This narrative review aims to highlight the importance of assessing frailty as an aid to guide therapeutic decision-making and tailor CAD management to the specific needs of older adults, taking into account age-related pharmacokinetic and pharmacodynamic changes, polypharmacy, and potential drug interactions. We also discuss gaps in the evidence and offer perspectives on how best in the future to optimize the global strategy of CAD management in older adults.
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Cacciatore et al. (2023) studied this question.
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