Introduction and Context
The United States is undergoing a dramatic demographic transition: the number and proportion of older adults are rising rapidly, and cardiovascular disease remains the leading cause of morbidity and mortality in this group. The American Heart Association’s 2025 scientific statement “Coronary Artery Revascularization in the Older Adult Population” (Damluji et al., Circulation 2025) responds to major clinical gaps: most revascularization guidelines and trials historically under-represent older adults and rarely address geriatric syndromes (frailty, cognitive impairment, multimorbidity) that materially influence risks, benefits, and patient preferences.
This statement is not a prescriptive guideline that replaces ACC/AHA/ESC revascularization guidance; rather, it is a focused, pragmatic framework designed to help clinicians incorporate geriatric principles into revascularization decisions for older adults. It centers on individualized risk–benefit assessment, integration of geriatric evaluation into the heart-team process, and shared decision-making that reflects life expectancy, functional goals, and patient values.
