Cold-driven biphasic vascular healing in elderly patients: 4D optical coherence tomography stratification of major adverse cardiovascular event risk based on age-environment interactions

In older patients, the interaction between aging and prolonged cold exposure results in biphasic vascular healing, characterized by early delayed endothelialization followed by excessive neointimal proliferation. The proposed 4-D Risk Score may facilitate individualized risk stratification after percutaneous coronary intervention and warrants prospective validation.