Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Section of Cardiology, Baylor College of Medicine, Houston, TX, USA.
Curr Atheroscler Rep. 2024 Jul;26(7):231-248. doi: 10.1007/s11883-024-01203-9. Epub 2024 May 9.
To provide a comprehensive summary of relevant studies and evidence concerning the utilization of different pharmacotherapeutic and revascularization strategies in managing coronary artery disease and acute coronary syndrome specifically in the older adult population.
Approximately 30% to 40% of hospitalized patients with acute coronary syndrome are older adults, among whom the majority of cardiovascular-related deaths occur. When compared to younger patients, these individuals generally experience inferior clinical outcomes. Most clinical trials assessing the efficacy and safety of various therapeutics have primarily enrolled patients under the age of 75, in addition to excluding those with geriatric complexities. In this review, we emphasize the need for a personalized and comprehensive approach to pharmacotherapy for coronary heart disease and acute coronary syndrome in older adults, considering concomitant geriatric syndromes and age-related factors to optimize treatment outcomes while minimizing potential risks and complications. In the realm of clinical practice, cardiovascular and geriatric risks are closely intertwined, with both being significant factors in determining treatments aimed at reducing negative outcomes and attaining health conditions most valued by older adults.
提供有关在老年人群中管理冠心病和急性冠脉综合征时使用不同药物治疗和血运重建策略的相关研究和证据的全面总结。
大约 30%至 40%的急性冠脉综合征住院患者为老年人，其中大多数心血管相关死亡发生在这些人群中。与年轻患者相比，这些人通常临床结局较差。大多数评估各种治疗方法疗效和安全性的临床试验主要纳入了 75 岁以下的患者，此外还排除了存在老年复杂性的患者。在这篇综述中，我们强调需要针对老年患者的冠心病和急性冠脉综合征采用个体化和综合的药物治疗方法，同时考虑伴随的老年综合征和与年龄相关的因素，以优化治疗效果，同时最大限度地降低潜在风险和并发症。在临床实践中，心血管风险和老年风险密切相关，两者都是确定旨在降低负面结果和实现老年人最看重的健康状况的治疗方法的重要因素。
