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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Feb 26, 2026; 18(2): 114706
Published online Feb 26, 2026. doi: 10.4330/wjc.v18.i2.114706
Published online Feb 26, 2026. doi: 10.4330/wjc.v18.i2.114706
Frailty first: Rethinking invasive strategies for elderly patients with non-ST-elevation myocardial infarction
Nikias Milaras, Skevos Sideris, Department of Cardiology, “Hippokration” General Hospital, Athens 11527, Greece
Konstantinos Toutouzas, 1st Department of Cardiology, “Hippokration” General Hospital, Athens Medical School, Athens 11527, Greece
Author contributions: Milaras N drafted the manuscript and revised it; Toutouzas K and Sideris S provided critical review, supervision, and final approval of the version to be published.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nikias Milaras, Academic Fellow, Department of Cardiology, “Hippokration” General Hospital, Vasilisis Sofias 14, Athens 11527, Greece.
Received: September 26, 2025
Revised: November 2, 2025
Accepted: December 24, 2025
Published online: February 26, 2026
Processing time: 136 Days and 12.4 Hours
Revised: November 2, 2025
Accepted: December 24, 2025
Published online: February 26, 2026
Processing time: 136 Days and 12.4 Hours
Core Tip
Core Tip: Frailty influences outcomes in elderly patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary intervention (PCI). In a large United States cohort, PCI reduced in-hospital mortality across all frailty levels, yet benefits declined and complications, length of stay, and costs rose with increasing frailty. These findings highlight that frailty should not preclude PCI but must be routinely assessed to guide individualized decision-making, risk prediction, and resource allocation in acute coronary care.