Impact of frailty on post-procedural adverse outcomes in older adults aged ≥75 years undergoing percutaneous coronary intervention: a systematic review of observational studies

By
Peng Tian
Liping Wang
Tianjiao He
Qiurong Zhang
Yingying Cai
May 14, 2026

Frontiers In Medicine

Overview

This systematic review evaluates the impact of frailty on clinical outcomes in patients aged ≥75 years undergoing percutaneous coronary intervention (PCI). Findings indicate that frailty significantly increases the risk of in-hospital mortality, all-cause mortality, bleeding, and stroke in this population.

Background

As the global population ages, more elderly patients are undergoing PCI, making it crucial to understand factors that influence outcomes. Frailty, a common syndrome in older adults, is associated with decreased physiological reserve and increased vulnerability to stressors, potentially complicating surgical outcomes. Recognizing frailty as an independent risk factor can aid in better risk stratification and management of elderly patients undergoing PCI.

Data Highlights

{'stroke': {'RR': 1.9, 'CI': '1.86–1.94'}}

Key Findings

Frail patients aged ≥75 years have a significantly higher risk of in-hospital death (RR = 3.16).
Frailty is associated with increased all-cause mortality (RR = 2.51).
There is a higher incidence of bleeding complications in frail patients (RR = 2.26).
Frail patients also face an increased risk of stroke (RR = 1.90).
The GRADE evidence certainty was low across all outcomes assessed.

Clinical Implications

Healthcare providers should incorporate frailty assessments into preoperative evaluations for patients aged ≥75 years undergoing PCI. Understanding the frailty status can guide shared decision-making and individualized management strategies to mitigate risks associated with PCI.

Conclusion

Frailty significantly impacts clinical outcomes following PCI in elderly patients, highlighting the need for careful risk assessment and management. These findings underscore the importance of tailoring treatment approaches to the frailty status of patients.