Optimal medical therapy after MI in the elderly.
After an MI, elderly persons should have their modifiable coronary artery risk factors--such as hypertension, dyslipidemia, and diabetes--intensively treated. Aspirin or clopidogrel, beta-blockers, and ACE inhibitors should be given indefinitely, unless contraindications exist. Long-acting nitrates are effective antianginal and anti-ischemic drugs. There are no Class I indications for the use of calcium channel blockers after MI. Postinfarction patients should not receive Class I antiarrhythmic drugs, sotalol, or amiodarone. Those at very high risk for sudden cardiac death should have an implantable cardioverter-defibrillator. Hormonal therapy should not be used in postmenopausal women after MI. The indications for coronary revascularization are prolongation of life and relief of unacceptable symptoms despite optimal medical management.
Aronow
Wilbert S
WS
Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, NY, USA.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D003324:Coronary Artery Disease; D017147:Defibrillators, Implantable; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors