{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T10:36:21Z","timestamp":1788690981360,"version":"build-2803163510"},"reference-count":146,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T00:00:00Z","timestamp":1691712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore","award":["D1.2020"],"award-info":[{"award-number":["D1.2020"]}]},{"name":"Universit\u00e0 Cattolica del Sacro Cuore","award":["D1.2022"],"award-info":[{"award-number":["D1.2022"]}]},{"name":"Universit\u00e0 Cattolica del Sacro Cuore","award":["D1.2023"],"award-info":[{"award-number":["D1.2023"]}]},{"name":"Universit\u00e0 Cattolica del Sacro Cuore","award":["CUP B53C22004000006"],"award-info":[{"award-number":["CUP B53C22004000006"]}]},{"name":"Italian Ministry of Health","award":["D1.2020"],"award-info":[{"award-number":["D1.2020"]}]},{"name":"Italian Ministry of Health","award":["D1.2022"],"award-info":[{"award-number":["D1.2022"]}]},{"name":"Italian Ministry of Health","award":["D1.2023"],"award-info":[{"award-number":["D1.2023"]}]},{"name":"Italian Ministry of Health","award":["CUP B53C22004000006"],"award-info":[{"award-number":["CUP B53C22004000006"]}]},{"name":"Centro Studi Achille e Linda Lorenzon","award":["D1.2020"],"award-info":[{"award-number":["D1.2020"]}]},{"name":"Centro Studi Achille e Linda Lorenzon","award":["D1.2022"],"award-info":[{"award-number":["D1.2022"]}]},{"name":"Centro Studi Achille e Linda Lorenzon","award":["D1.2023"],"award-info":[{"award-number":["D1.2023"]}]},{"name":"Centro Studi Achille e Linda Lorenzon","award":["CUP B53C22004000006"],"award-info":[{"award-number":["CUP B53C22004000006"]}]},{"name":"Next Generation EU","award":["D1.2020"],"award-info":[{"award-number":["D1.2020"]}]},{"name":"Next Generation EU","award":["D1.2022"],"award-info":[{"award-number":["D1.2022"]}]},{"name":"Next Generation EU","award":["D1.2023"],"award-info":[{"award-number":["D1.2023"]}]},{"name":"Next Generation EU","award":["CUP B53C22004000006"],"award-info":[{"award-number":["CUP B53C22004000006"]}]},{"name":"Union-NextGenerationEU","award":["D1.2020"],"award-info":[{"award-number":["D1.2020"]}]},{"name":"Union-NextGenerationEU","award":["D1.2022"],"award-info":[{"award-number":["D1.2022"]}]},{"name":"Union-NextGenerationEU","award":["D1.2023"],"award-info":[{"award-number":["D1.2023"]}]},{"name":"Union-NextGenerationEU","award":["CUP B53C22004000006"],"award-info":[{"award-number":["CUP B53C22004000006"]}]},{"name":"European Union-NextGenerationEU","award":["D1.2020"],"award-info":[{"award-number":["D1.2020"]}]},{"name":"European Union-NextGenerationEU","award":["D1.2022"],"award-info":[{"award-number":["D1.2022"]}]},{"name":"European Union-NextGenerationEU","award":["D1.2023"],"award-info":[{"award-number":["D1.2023"]}]},{"name":"European Union-NextGenerationEU","award":["CUP B53C22004000006"],"award-info":[{"award-number":["CUP B53C22004000006"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/jcm12165233","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T12:10:23Z","timestamp":1691755823000},"page":"5233","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Management of Coronary Artery Disease in Older Adults: Recent Advances and Gaps in Evidence"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7504-3775","authenticated-orcid":false,"given":"Stefano","family":"Cacciatore","sequence":"first","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Universit\u00e0 Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6443-4121","authenticated-orcid":false,"given":"Luigi","family":"Spadafora","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9269-8829","authenticated-orcid":false,"given":"Marco","family":"Bernardi","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Galli","sequence":"additional","affiliation":[{"name":"Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Betti","sequence":"additional","affiliation":[{"name":"University of Milan, 20122, Milan, Italy"},{"name":"Monzino IRCCS Cardiological Center, 20137 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1418-7908","authenticated-orcid":false,"given":"Francesco","family":"Perone","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Unit, Rehabilitation Clinic \u201cVilla delle Magnolie\u201d, 81020 Castel Morrone, Caserta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Nicolaio","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine and Geriatrics, University of Florence, Azienda Ospedaliero Universitaria Careggi, Largo Giovanni Alessandro Brambilla 3, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9567-6983","authenticated-orcid":false,"given":"Emanuele","family":"Marzetti","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Universit\u00e0 Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy"},{"name":"Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Martone","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Landi","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Universit\u00e0 Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy"},{"name":"Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3381-605X","authenticated-orcid":false,"given":"Elad","family":"Asher","sequence":"additional","affiliation":[{"name":"The Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University, P.O. Box 12271, Jerusalem 9112102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6690-6874","authenticated-orcid":false,"given":"Maciej","family":"Banach","sequence":"additional","affiliation":[{"name":"Department of Preventive Cardiology, Polish Mother\u2019s Memorial Hospital Research Institute (PMMHRI), Medical University of Lodz (MUL), 93-338 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Hanon","sequence":"additional","affiliation":[{"name":"Assistance Publique H\u00f4pitaux de Paris, Geriatric Department, Broca Hospital, University of Paris Cit\u00e9, 54\u201356 Rue Pascal, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6103-8510","authenticated-orcid":false,"given":"Giuseppe","family":"Biondi-Zoccai","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy"},{"name":"Mediterranea Cardiocentro, Via Orazio 2, 80122 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0243-3673","authenticated-orcid":false,"given":"Pierre","family":"Sabouret","sequence":"additional","affiliation":[{"name":"Heart Institute, Piti\u00e9-Salp\u00e9tri\u00e8re Hospital, ACTION-Group, Sorbonne University, 47\u201383 Bd de l\u2019H\u00f4pital, 75013 Paris, France"},{"name":"Department of Cardiology, National College of French Cardiologists, 13 Rue Ni\u00e9pce, 75014 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1093\/eurheartj\/ehx239","article-title":"Aging: The next cardiovascular disease?","volume":"38","author":"Camici","year":"2017","journal-title":"Eur. 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