Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Sep 14;10(18):4132.
doi: 10.3390/jcm10184132.

Acute Coronary Syndrome in the Older Patient

Sergio García-Blas  1   2 , Alberto Cordero  2   3 , Pablo Diez-Villanueva  4 , Maria Martinez-Avial  4 , Ana Ayesta  5 , Albert Ariza-Solé  6 , Gemma Mateus-Porta  6 , Manuel Martínez-Sellés  2   7 , David Escribano  2   3 , Ana Gabaldon-Perez  1 , Vicente Bodi  1   2 , Clara Bonanad  1
Affiliations
Review

Acute Coronary Syndrome in the Older Patient

Sergio García-Blas et al. J Clin Med. .

Abstract

Coronary artery disease is one of the leading causes of morbidity and mortality, and its prevalence increases with age. The growing number of older patients and their differential characteristics make its management a challenge in clinical practice. The aim of this review is to summarize the state-of-the-art in diagnosis and treatment of acute coronary syndromes in this subgroup of patients. This comprises peculiarities of ST-segment elevation myocardial infarction (STEMI) management, updated evidence of non-STEMI therapeutic strategies, individualization of antiplatelet treatment (weighting ischemic and hemorrhagic risks), as well as assessment of geriatric conditions and ethical issues in decision making.

Keywords: acute coronary syndrome; elderly; myocardial infarction.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Management of acute ST-segment elevation myocardial infarction. Adapted from [16]. EKG: electrocardiogram; PCI: percutaneous coronary intervention. * Atypical presentation is common.
See this image and copyright information in PMC

References

    1. Benjamin E.J., Blaha M.J., Chiuve S.E., Cushman M., Das S.R., Deo R., de Ferranti S.D., Floyd J., Fornage M., Gillespie C., et al. Heart Disease and Stroke Statistics—2017 Update: A Report from the American Heart Association. Circulation. 2017;135:e146–e603. doi: 10.1161/CIR.0000000000000485. - DOI - PMC - PubMed
    1. Townsend N., Nichols M., Scarborough P., Rayner M. Cardiovascular disease in Europe-epidemiological update 2015. Eur. Heart J. 2015;36:2696–2705. doi: 10.1093/eurheartj/ehv428. - DOI - PubMed
    1. Topaz G., Finkelstein A., Flint N., Shacham Y., Banai S., Steinvil A., Arbel Y., Keren G., Yankelson L. Comparison of 30-day and long-term outcomes and hospital complications among patients aged <75 versus ≥75 years with ST-elevation myocardial infarction undergoing percutaneous coronary intervention. Am. J. Cardiol. 2017;119:1897–1901. doi: 10.1016/j.amjcard.2017.03.014. - DOI - PubMed
    1. Ariza-Solé A., Alegre O., Elola F.J., Fernández C., Formiga F., Martínez-Sellés M., Bernal J.L., Segura J.V., Iñíguez A., Bertomeu V., et al. Management of myocardial infarction in the elderly. Insights from Spanish Minimum Basic Data Set. Eur. Heart J. Acute Cardiovasc. Care. 2019;8:242–251. doi: 10.1177/2048872617719651. - DOI - PubMed
    1. Alvarez Alvarez B., Cid Alvarez A.B., Redondo Dieguez A., Sanmartin Pena X., Lopez Otero D., Avila Carrillo A., Gomez Peña F., Trillo Nouche R., Martinez Selles M., Gonzalez-Juanatey J. Short-term and long-term validation of the fastest score in patients with ST-elevation myocardial infarction after primary angioplasty. Int. J. Cardiol. 2018;269:19–22. doi: 10.1016/j.ijcard.2018.07.108. - DOI - PubMed