Is the contemporary care of the older persons with acute coronary syndrome evidence-based?

TY - JOUR

T1 - Is the contemporary care of the older persons with acute coronary syndrome evidence-based?

AU - Mills, Greg B

AU - Ratcovich, Hanna

AU - Adams-Hall, Jennifer

AU - Beska, Benjamin

AU - Kirkup, Emma

AU - Raharjo, Daniell E

AU - Veerasamy, Murugapathy

AU - Wilkinson, Chris

AU - Kunadian, Vijay

N1 - © The Author(s) 2021

PY - 2022/1/11

Y1 - 2022/1/11

N2 - Globally, ischaemic heart disease is the leading cause of death, with a higher mortality burden amongst older adults. Although advancing age is associated with a higher risk of adverse outcomes following acute coronary syndrome (ACS), older patients are less likely to receive evidence-based medications and coronary angiography. Guideline recommendations for managing ACS are often based on studies that exclude older patients, and more contemporary trials have been underpowered and produced inconsistent findings. There is also limited evidence for how frailty and comorbidity should influence management decisions. This review focuses on the current evidence base for the medical and percutaneous management of ACS in older patients and highlights the distinct need to enrol older patients with ACS into well-powered, large-scale randomized trials.

AB - Globally, ischaemic heart disease is the leading cause of death, with a higher mortality burden amongst older adults. Although advancing age is associated with a higher risk of adverse outcomes following acute coronary syndrome (ACS), older patients are less likely to receive evidence-based medications and coronary angiography. Guideline recommendations for managing ACS are often based on studies that exclude older patients, and more contemporary trials have been underpowered and produced inconsistent findings. There is also limited evidence for how frailty and comorbidity should influence management decisions. This review focuses on the current evidence base for the medical and percutaneous management of ACS in older patients and highlights the distinct need to enrol older patients with ACS into well-powered, large-scale randomized trials.

U2 - 10.1093/ehjopen/oeab044

DO - 10.1093/ehjopen/oeab044

M3 - Article

C2 - 35919658

SN - 2752-4191

VL - 2

JO - European heart journal open

JF - European heart journal open

IS - 1

M1 - oeab044

ER -