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. 2021 Mar 28;18(3):210-218.
doi: 10.11909/j.issn.1671-5411.2021.03.010.

Optimal dual antiplatelet therapy strategy in elderly patients with acute coronary syndrome

Monica Verdoia  1 , Rocco Gioscia  1 , Giuseppe De Luca  1
Affiliations

Optimal dual antiplatelet therapy strategy in elderly patients with acute coronary syndrome

Monica Verdoia et al. J Geriatr Cardiol. .

Abstract

One out of three hospitalizations for acute coronary syndrome (ACS) involve nowadays elderly patients, carrying together a significant burden of comorbidities and a higher risk of complications. In particular, both ischemic and haemorrhagic risk are markedly enhanced in advanced age, and strictly interconnected, challenging the management of dual antiplatelet therapy (DAPT) in these patients. The recent development of several therapeutic options in terms of duration and combination of antiplatelet agents have offered a wider spectrum of opportunities for a more individualized approach in the management of DAPT after an ACS, although the criteria for the selection of the most appropriate strategy in each patient still lack validation. In particular, dose-adjustment, early aspirin discontinuation, laboratory-driven tailoring and shorter or extended DAPT have been addressed with promising safety and efficacy results. The present review provides an updated overview on the emerging evidencefrom randomized clinical trials and subanalyses dedicated to the management of DAPT in elderly patients presenting with ACS.

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Figures

Figure 1
Figure 1
Death and myocardial infarction in elderly patients presenting with acute coronary syndrome.
Figure 2
Figure 2
Clopidogrel vs. new ADP antagonists in elderly patients.
Figure 3
Figure 3
Short vs.standard DAPT in elderly patients for study primary endpoint.
See this image and copyright information in PMC

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