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Published on: July 26, 2024

Frailty and Coronary Artery Disease: Proposed Pathophysiology and A Complex Interaction Influencing Management and

Ammar Albayati1, Lloyd Butel-Simoes2, Payal Gadre1

  • 1John Hunter Hospital, Cardiovascular Department, Newcastle, NSW, Australia.

Heart, Lung & Circulation
|May 13, 2026
PubMed

Insights

Coronary artery disease (CAD) and frailty often occur together in older adults, impacting treatment and outcomes. Assessing frailty is crucial for personalized care and better results in cardiovascular medicine.

Area of Science:

  • Cardiology
  • Geriatrics
  • Public Health

Background:

  • Coronary artery disease (CAD) and frailty are common in aging populations.
  • Frailty, characterized by reduced physiological reserve, is prevalent in older CAD patients and linked to adverse outcomes.

Purpose of the Study:

  • To review the interplay between frailty and CAD.
  • To explore frailty's impact on CAD presentation, risk stratification, and treatment.
  • To discuss frailty assessment tools and their role in cardiovascular practice.

Main Methods:

  • Literature review examining shared pathophysiological mechanisms.
  • Analysis of frailty's influence on clinical management and outcomes.
  • Discussion of current frailty assessment tools in cardiovascular settings.

Main Results:

  • Frailty significantly affects the use and effectiveness of CAD therapies, including medications, interventions, and rehabilitation.
  • Treatment disparities exist due to frailty, impacting patient outcomes.
  • No single frailty assessment tool is universally adopted in cardiology.

Conclusions:

  • Integrating frailty assessment into routine cardiovascular care can enhance individualized management and shared decision-making.
  • Future research should focus on frailty-inclusive trials and cardiogeriatric approaches for vulnerable populations.
  • Optimizing care for older adults with CAD and frailty requires a multidisciplinary approach.

Keywords:
Acute coronary syndromeAgeingCoronary artery diseaseFrailty

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