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Review
. 2017 Oct 2:6:1791.
doi: 10.12688/f1000research.11064.1. eCollection 2017.

Acute Coronary Syndromes in the Elderly

Niels Engberding  1 , Nanette K Wenger  2   3
Affiliations
Review

Acute Coronary Syndromes in the Elderly

Niels Engberding et al. F1000Res. .

Abstract

The clinical evidence for treatment of acute coronary syndrome (ACS) in the elderly is less robust than in patients younger than 75 years. The elderly have the highest incidence of cardiovascular disease and frequently present with ACS. This number can be expected to increase over time because society is aging. Older adults often sustain unfavorable outcomes from ACS because of atypical presentation and delay in recognition. In addition, elderly patients commonly do not receive optimal guideline-directed ACS treatment. Owing to their high baseline risk of ischemic complications, the elderly also fare worse even with optimal ACS treatment as they frequently have more complex coronary disease, more comorbidities, less cardiovascular reserve, and a higher risk of treatment complications. They are also subjected to a broader range of pharmacologic treatment. Treatment complications can be mitigated to some extent by meticulous dose adjustment of antithrombotic and adjunctive therapies. While careful transitions of care and appropriate utilization of post-discharge secondary preventive measures are important in ACS patients of all ages, the elderly are more vulnerable to system errors and thus deserve special attention from the clinician.

Keywords: acute coronary; cardiovascular disease; elderly.

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Conflict of interest statement

Competing interests: The authors declare that they have no competing interests.No competing interests were disclosed.No competing interests were disclosed.No competing interests were disclosed.

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References

    1. Alexander KP, Newby LK, Cannon CP, et al. : Acute coronary care in the elderly, part I: Non-ST-segment-elevation acute coronary syndromes: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology. Circulation. 2007;115(19):2549–69. 10.1161/CIRCULATIONAHA.107.182615 - DOI - PubMed
    1. Roger VL, Jacobsen SJ, Weston SA, et al. : Trends in the incidence and survival of patients with hospitalized myocardial infarction, Olmsted County, Minnesota, 1979 to 1994. Ann Intern Med. 2002;136(5):341–8. 10.7326/0003-4819-136-5-200203050-00005 - DOI - PubMed
    1. Lee PY, Alexander KP, Hammill BG, et al. : Representation of elderly persons and women in published randomized trials of acute coronary syndromes. JAMA. 2001;286(6):708–13. 10.1001/jama.286.6.708 - DOI - PubMed
    1. Goldberg RJ, McCormick D, Gurwitz JH, et al. : Age-related trends in short- and long-term survival after acute myocardial infarction: a 20-year population-based perspective (1975–1995). Am J Cardiol. 1998;82(11):1311–7. 10.1016/S0002-9149(98)00633-X - DOI - PubMed
    1. Lopes RD, Gharacholou SM, Holmes DN, et al. : Cumulative incidence of death and rehospitalization among the elderly in the first year after NSTEMI. Am J Med. 2015;128(6):582–90. 10.1016/j.amjmed.2014.12.032 - DOI - PubMed

    2. F1000 Recommendation

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