This study is a prospective multi-center observational cohort involving elderly patients (≥70 years old) with multi-vessel coronary disease identified by coronary computed tomography angiography (cCTA) and scheduled for invasive coronary angiography. Data collection about cCTA, frailty and biomarkers and two-year follow-up will be conducted to develop and validate a risk model of coronary revascularization.

Inclusion Criteria:

1. Age ≥ 70 years.
2. Multivessel coronary artery disease identified on coronary computed tomography angiography (CCTA), defined as ≥50% stenosis in at least two of the three major epicardial coronary arteries.
3. Scheduled to undergo invasive coronary angiography as part of standard clinical care.
4. Able to provide informed consent, or consent provided by a legally authorized representative.

Exclusion Criteria:

1. Previous coronary revascularization, including percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).
2. Acute myocardial infarction at admission, according to electrocardiographic findings and elevated cardiac biomarkers consistent with acute MI.
3. Poor-quality CCTA images that prevent accurate assessment of coronary plaque characteristics or stenosis severity.
4. Refusal or inability to participate in the study or to provide informed consent.

Elderly patients aged 70 years and older with multivessel coronary artery disease identified by coronary CT angiography and scheduled to undergo invasive coronary angiography at participating centers.