Alfredsson Joakim, Alexander Karen P
Department of Cardiology, Linköping University, Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA.
Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA.
Clin Geriatr Med. 2016 May;32(2):291-303. doi: 10.1016/j.cger.2016.01.009. Epub 2016 Feb 18.
Older adults presenting with acute coronary syndromes (ACSs) often have multiple chronic conditions (MCCs). In addition to traditional cardiovascular (CV) risk factors (ie, hypertension, hyperlipidemia, and diabetes), common CV comorbidities include heart failure, stroke, and atrial fibrillation, whereas prevalent non-CV comorbidities include chronic kidney disease, anemia, depression, and chronic obstructive pulmonary disease. The presence of MCCs affects the presentation (eg, increased frequency of type 2 myocardial infarctions [MIs]), clinical course, and prognosis of ACS in older adults. In general, higher comorbidity burden increases mortality following MI, reduces utilization of ACS treatments, and increases the importance of developing individualized treatment plans.
患有急性冠状动脉综合征(ACS)的老年人通常患有多种慢性疾病(MCC)。除了传统的心血管(CV)危险因素(即高血压、高脂血症和糖尿病)外,常见的心血管合并症包括心力衰竭、中风和心房颤动,而常见的非心血管合并症包括慢性肾病、贫血、抑郁症和慢性阻塞性肺疾病。MCC的存在会影响老年人ACS的表现(例如,2型心肌梗死[MI]的发生率增加)、临床病程和预后。一般来说,更高的合并症负担会增加心肌梗死后的死亡率,降低ACS治疗的利用率,并增加制定个体化治疗方案的重要性。