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Author Notes:

Corresponding author: Nanette K. Wenger, nwenger@emory.edu

F1000 Faculty Reviews are commissioned from members of the prestigious F1000 Faculty and are edited as a service to readers. In order to make these reviews as comprehensive and accessible as possible, the referees provide input before publication and only the final, revised version is published.

The referees who approved the final version are listed with their names and affiliations but without their reports on earlier versions (any comments will already have been addressed in the published version).

The referees who approved this article are: Sanjay Patel, Sydney Medical School, University of Sydney, Sydney, Australia. No competing interests were disclosed.

Stefano Savonitto, Division of Cardiology, Manzoni Hospital, Lecco, Italy. No competing interests were disclosed.

Anna Sonia Petronio, University of Pisa, Pisa, Italy. No competing interests were disclosed.

The authors declare that they have no competing interests.

Subjects:

Research Funding:

The author(s) declared that no grants were involved in supporting this work.

Keywords:

  • acute coronary
  • cardiovascular disease
  • elderly

Acute Coronary Syndromes in the Elderly

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Journal Title:

F1000Research

Volume:

Volume 6

Publisher:

, Pages 1791-1791

Type of Work:

Article | Final Publisher PDF

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.

Copyright information:

© 2017 Engberding N and Wenger NK.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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