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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): 115016
Published online Feb 26, 2026. doi: 10.4330/wjc.v18.i2.115016
Published online Feb 26, 2026. doi: 10.4330/wjc.v18.i2.115016
Frailty in elderly patients with non-ST elevation myocardial infarction: Balancing the risks and benefits of percutaneous coronary intervention
Hussam Ali, Riccardo Cappato, Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni 20099, Milan, Italy
Flavio Airoldi, Interventional Cardiology Unit, IRCCS MultiMedica, Sesto San Giovanni 20099, Milan, Italy
Author contributions: Ali H drafted the manuscript; Airoldi F provided critical revision of the content; Cappato R supervised the editorial concept and final editing; All authors approved the final version of the manuscript.
Conflict-of-interest statement: Authors do not report any disclosures relevant to the content of this paper.
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: Hussam Ali, MD, FESC, Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni 20099, Milan, Italy.
Received: October 9, 2025
Revised: November 7, 2025
Accepted: December 22, 2025
Published online: February 26, 2026
Processing time: 126 Days and 6.6 Hours
Revised: November 7, 2025
Accepted: December 22, 2025
Published online: February 26, 2026
Processing time: 126 Days and 6.6 Hours
Core Tip
Core Tip: Frailty is increasingly recognized as a key determinant of outcomes in elderly patients with non-ST elevation myocardial infarction, yet its role in guiding invasive management remains debated. The recent analysis by Popat et al suggests that percutaneous coronary intervention may confer survival benefit across frailty categories, while also exposing patients to higher risks of complications, longer hospitalizations, and greater costs. These findings highlight the complexity of decision-making in this vulnerable cohort. In this letter to the editor, we reflect on these results and discuss them in the context of current literature, practice guidelines, and future directions.