Acute medical management of the non-ST-segment elevation acute coronary syndromes (NSTE-ACS) in older patients.
Older patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) represent many clinical challenges. For example diagnosis can be difficult, and comorbidities are common. Furthermore, NSTE-ACS is particularly common in older patients (>60% of acute myocardial infarctions occurring in patients aged 65 years or older) and the mortality associated with NSTE-ACS is particularly high. Despite these many concerns, evidence from clinical trials based on this group of patients is limited. Future prospective clinical trials should therefore more accurately reflect the NSTE-ACS patient population by including more elderly patients and including efficacy endpoints that are relevant for these patients. Furthermore, the lack of clear clinical evidence in this population means that the current treatment guidelines do not fully address the needs of elderly patients. Several recent clinical trials have highlighted some of the main considerations we should make when treating elderly patients with NSTE-ACS. Different therapy options in the pharmacological management of NSTE-ACS in this age group are also discussed.
Docherty
Andrew
A
Wishaw General Hospital, 50 Netherton Street, Wishaw ML2 0DP, UK. AndrewXDocherty@aol.com
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D015897:Comorbidity; D004562:Electrocardiography; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D016896:Treatment Outcome
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors