Predictors of major adverse cardiac events in elderly cardiac patients with coronary artery disease
DOI:
https://doi.org/10.5281/zenodo.22814677Keywords:
coronary artery disease, major adverse cardiac events, elderly, frailty, risk predictionAbstract
Background: Elderly patients with coronary artery disease (CAD) carry a disproportionate burden of major adverse cardiac events (MACE), yet risk scores derived largely from younger cohorts often fail to capture the geriatric-specific determinants of outcome.
Objective: This review synthesizes published evidence on predictors of MACE in elderly CAD patients, spanning traditional risk factors, frailty and geriatric syndromes, biomarkers, comorbidity burden, and revascularization strategy.
Methods: We synthesized cohort studies, registry analyses, and trial substudies addressing risk stratification in patients aged 65 years and older with stable or acute CAD.
Findings: Age-adjusted risk scores such as GRACE and TIMI retain value but underweight frailty, multimorbidity, renal dysfunction, and anemia, each of which independently predicts MACE and, alongside natriuretic peptide and troponin measurement, improves discrimination beyond traditional models; anatomical complexity and revascularization completeness further modify risk.
Conclusions: Reliable MACE prediction in elderly CAD patients requires integrating traditional risk factors with frailty assessment, comorbidity indices, and biomarkers, with future models prospectively validated in geriatric cohorts rather than extrapolated from younger populations.
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