García-Blas Sergio, Cordero Alberto, Diez-Villanueva Pablo, Martinez-Avial Maria, Ayesta Ana, Ariza-Solé Albert, Mateus-Porta Gemma, Martínez-Sellés Manuel, Escribano David, Gabaldon-Perez Ana, Bodi Vicente, Bonanad Clara
Cardiology Department, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, 46010 Valencia, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain.
J Clin Med. 2021 Sep 14;10(18):4132. doi: 10.3390/jcm10184132.
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.
冠状动脉疾病是发病和死亡的主要原因之一，其患病率随年龄增长而增加。老年患者数量的不断增加及其不同的特征使得其管理成为临床实践中的一项挑战。本综述的目的是总结该亚组患者急性冠状动脉综合征诊断和治疗的最新进展。这包括ST段抬高型心肌梗死（STEMI）管理的特点、非STEMI治疗策略的最新证据、抗血小板治疗的个体化（权衡缺血和出血风险），以及老年患者情况评估和决策中的伦理问题。
