{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T18:32:42Z","timestamp":1786559562510,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Backgrounds<\/jats:title>\n                    <jats:p>Older adults constitute a growing proportion of patients presenting with acute coronary syndrome (ACS); optimal management remains uncertain due to comorbidities, frailty, procedure\u2010related complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to identify prognostic determinants and to evaluate the impact of invasive management strategies on short\u2010 and long\u2010term outcomes in elderly patients with ACS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed consecutive ACS patients aged\u2009\u2265\u200975 years who underwent coronary angiography. Frailty was assessed within the first 48\u2009h of admission using the Rockwood Clinical Frailty Scale (CFS). Sex\u2010related differences, frailty, treatment strategies (percutaneous coronary intervention [PCI] vs. conservative\/medical therapy), predictors of short\u2010 and long\u2010term outcomes were assessed. The primary endpoint was all\u2010cause mortality; secondary endpoints included major adverse cardiac and cerebrovascular events (MACCEs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 627 patients were included (46% women), with non\u2013ST\u2010elevation ACS (NSTE\u2010ACS) as the predominant presentation (66.8%). Patients presenting with ST\u2010elevation myocardial infarction (STEMI) experienced significantly higher in\u2010hospital mortality (19.7% vs.5.7%) and MACCEs rates (50.5% vs. 22%; both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared with those with NSTE\u2010ACS. In\u2010hospital and 1\u2010year mortality did not differ by sex. Shock, frailty, contrast\u2010induced nephropathy, peak troponin levels as independent predictors of in\u2010hospital mortality, whereas frailty, reduced left ventricular ejection fraction, peak troponin independently predicted long\u2010term mortality. Among patients with NSTE\u2010ACS, PCI was associated with lower in\u2010hospital mortality (3.5% vs. 8.4%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040) but higher rates of in\u2010hospital and long\u2010term adverse events, without a significant reduction in 1\u2010year mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Frailty is a dominant determinant of both short\u2010 and long\u2010term mortality and should be systematically incorporated into early risk stratification. A selective, frailty\u2010guided invasive strategy may improve early survival whereas routine intervention appears unjustified given the lack of long\u2010term benefit and increased complication risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70635","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T03:32:00Z","timestamp":1777001520000},"page":"197-205","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gender Differences in Risk Factors, Management, and Outcomes of Elderly Patients With Acute Coronary Syndrome: The Interplay of Frailty"],"prefix":"10.1002","volume":"108","author":[{"given":"Sabiye","family":"Y\u0131lmaz","sequence":"first","affiliation":[{"name":"Department of Cardiology Health Sciences University, Kocaeli City Hospital Kocaeli Kocaeli T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"U\u011fur","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kocaeli City Hospital Kocaeli T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saadet D.","family":"\u0130nci","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ankara Etlik City Hospital Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kahraman","family":"Co\u015fansu","sequence":"additional","affiliation":[{"name":"Department of Cardiology T\u00fcrkiye Hospital  \u0130stanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhsin O.","family":"\u00c7elik","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kocaeli City Hospital Kocaeli 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