Frailty and nutrition in older adults with ACS: advancing risk stratification and care—a commentary

This invited commentary refers to ‘Older adults with acute coronary syndrome: the impact of frailty and nutritional status on in-hospital complications’, by M. Jiménez-Salva et al., https://doi.org/10.1093/eurjcn/zvaf006. The management of acute coronary syndrome (ACS) in older adults presents unique challenges, with frailty and nutritional status emerging as critical factors influencing patient outcomes. The study by Jiménez-Salva et al., titled ‘Older adults with acute coronary syndrome: The impact of frailty and nutritional status on in-hospital complications’, provides valuable insights into the role these factors play during hospitalization.1 This commentary explores the study’s findings, contextualizes their implications within broader clinical practice, and identifies future research directions. Frailty, characterized by diminished physiological reserve and vulnerability to stressors, is a growing concern in geriatric cardiology.2 The authors utilized the FRAIL Scale (FS) to evaluate frailty among patients, identifying it as a significant independent predictor of net adverse clinical events (NACE) during hospitalization.2 These events, including ischaemic complications, bleeding, infections, and acute kidney injury, highlight the profound impact frailty has on older adults with ACS.