title: Optimal medical therapy after MI in the elderly.
abstract: 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.
authors.affiliation: Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, NY, USA.
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
mesh_terms: 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
chemical_list: D000319:Adrenergic beta-Antagonists; D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors