Frailty and acute coronary syndrome: does gender matter?

There are important sex-related differences in elderly patients with acute coronary syndrome (ACS). Women are older, more frequently frail, and present more comorbidities than men. Atypical symptoms at presentation are also more common in female patients, they are leaded to a delayed diagnosis and treatment. Coronary angiography and subsequent revascularization are frequently underused in elderly women and they tend to receive less guidelines-recommended therapies. The prognosis in elderly frail women with ACS is poor, and it is with high mortality and readmissions rates. Bleeding is recurrent ischemic events in which it is more frequent in women than in men. Recovery time might be long, and a multidisciplinary approach is desirable to improve prognosis and quality of life. Further studies are needed in order to clarify the benefit of the different therapies in the group of frail women, and this is particularly true for revascularization, as scientific evidence in this group is very scarce.