Vandermolen Sebastian, Abbott Jane, De Silva Kalpa
Specialist Registrar in Cardiology, St. Peter's Hospital, Surrey, UK.
Curr Cardiol Rev. 2015;11(3):199-208. doi: 10.2174/1573403x10666141020110122.
Currently a quarter of all patients treated with percutanous coronary intervention (PCI) are aged >75 years, with this proportion steadily growing. This subset of patients have a number of unique characteristics, such as a greater number of cardiovascular risk factors and frequently a larger burden of coronary artery disease, when compared to younger patients, therefore potentially deriving increased benefit from revascularization. Nonetheless this population are also more likely to experience procedural complications, secondary to age-related physiological alterations, increased frailty and increased prevalence of other co-morbidities. This article reviews the various aspects and data available to clinicians pertaining to and guiding revascularization in the elderly, including the use of adjuvant pharmacotherapy, specific considerations when considering age-related physiology, and revascularization in acute coronary syndromes.
目前，接受经皮冠状动脉介入治疗（PCI）的患者中有四分之一年龄超过75岁，且这一比例在稳步上升。与年轻患者相比，这类患者有许多独特的特征，如心血管危险因素更多，冠状动脉疾病负担通常也更大，因此可能从血运重建中获得更大益处。尽管如此，由于与年龄相关的生理变化、身体虚弱加剧以及其他合并症患病率增加，这一人群也更有可能出现手术并发症。本文综述了临床医生在老年人血运重建方面可获得的各个方面的信息和数据，包括辅助药物治疗的使用、考虑与年龄相关的生理因素时的特殊注意事项以及急性冠状动脉综合征中的血运重建。
