PERKÜTAN KORONER GİRİŞİMİN GERİATRİK HASTALARDA FONKSİYONEL PERFORMANS, KIRILGANLIK VE GERİATRİK SENDROMLAR ÜZERİNE ETKİSİ

Abstract

Uğur, M.U., The Impact of Percutaneous Coronary Intervention on Functional Performance, Frailty, and Geriatric Syndromes in Older Adults. Hacettepe University Faculty of Medicine, Thesis in Internal Medicine. Ankara, 2026. Objective: This study aimed to evaluate the changes in functional performance, frailty, and geriatric syndromes before and after percutaneous coronary intervention (PCI) in older adults with chronic coronary syndrome (CCS). Materials and Methods: In this retrospective, single-center study, 103 patients aged ≥65 years who underwent elective PCI and had comprehensive geriatric assessment data before and 6–12 months after the procedure were included. Patients were evaluated in terms of frailty (Clinical Frailty Scale, CFS), sarcopenia risk (SARC-F), nutritional status (Mini Nutritional Assessment–Short Form, MNA-SF), functional status (ADL/IADL), physical performance tests (4-meter gait speed, Timed Up and Go test, five times sit-to-stand test), and cognitive assessments(S-MMSE ,CDT). Subgroup analyses were performed according to treatment strategy (optimal medical therapy vs. revascularization). Results: Following PCI, a significant reduction in LDL levels and an increase in vitamin D levels were observed in the overall cohort. However, a general trend toward worsening in functional performance and frailty parameters was noted. An increase in CFS scores and a decline in ADL scores were more pronounced in male patients, whereas changes in muscle strength and mobility were more evident in females. Although revascularized patients showed greater improvement in certain metabolic parameters, functional gains remained limited. Patients with malnutrition demonstrated a weaker metabolic and functional response. The development of post-PCI acute kidney injury was associated with poorer clinical and functional outcomes. Conclusion: While PCI improves metabolic parameters in geriatric patients, its impact on functional status and frailty is heterogeneous and often limited. Geriatric parameters such as nutritional status, sarcopenia, and frailty are key determinants of post-PCI outcomes. Therefore, decision-making for revascularization in older adults should incorporate comprehensive geriatric assessment alongside cardiovascular parameters to enable individualized patient-centered care.