EDITORIAL

      83Acta Medica Indonesiana - The Indonesian Journal of Internal Medicine

Impact of Frailty on Cardiovascular Disease (and the Other 
Way Around)

Esthika Dewiasty
Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, 
Jakarta, Indonesia.

Corresponding Author:
Esthika Dewiasty, MD., MSc. Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine Universitas 
Indonesia – Cipto Mangunkusumo Hospital. Jl. Diponegoro 71, Jakarta 10430, Indonesia. Email: edewiasty@gmail.com.

Cardiovascular disesase has been identified 
as the most frequent cause of death, while 
frailty has been identified as one of geriatric 
giants characterized by decreased physiological 
reserves and increased vulnerability.1 Despite of 
aggressive treatment for cardiovascular diseases 
such as invasive methods,frail patients who 
undergo these procedures tend to experience 
undesirable effects compared to non frail 
patients.2 As the population of elderly patiens 
worldwide is growing larger, these issues lead to 
major health problems that we have to overcome. 

A s s o c i a t i o n  b e t w e e n  f r a i l t y  a n d 
cardiovascular disease is still debatable. 
Cardiovascular disease accelerates frailty. On 
the other hand, frail patients have higher risk 
of cardiac mortality and major cardiac events 
due to their complex health status.2 However, 
by doing good risk prediction and assessment, 
interventional treatment can be performed safely 
in selected older patients.3

To date, only a few studies have been 
conducted to investigate relationship between 
these two major health problems in elderly. 
Therefore, in this edition we highlight a study 
which investigate association between frailty 
and major adverse cardiac events in patients 
who underwent invasive intervention. Further 
researches are still needed to establish evidences 
between these two geriatric major health 
problems.

REFERENCES

1. Ekerstad N, Swahn E, Janzon M, et al. Frailty is 
independently associated with short-term outcomes 
for elderly patients with non-ST segment elevation 
myocardial infarction. Circulation. 2011;124(22):2397-
404.

2. Singh M, Rihal CS, Lennon RJ, et al. Outcomes in 
octogenarians undergoing percutaneous coronary 
interventions. Circ Cardiovasc Qual Outcomes. 
2011;4:496-502.

3. Lo DKY, Chan CK, Wong JT, et al. Outcomes in 
octogenarians undergoing percutaneous coronary 
interventions. Asian J Gerontol Geriatr. 2011;6:7-13.