Antithrombotic Therapy for ACS in Elderly Patients

Background Patients over 75 account for more than one third of those presenting with myocardial infarction and more than 50% of intrahospital mortality. There are no specific guidelines for the management of acute coronary syndromes (ACS) in the elderly. Setting Although antithrombotic therapy seems...

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Bibliographic Details
Published in:Cardiovascular drugs and therapy 2017-12, Vol.31 (5-6), p.609-618
Main Authors: Roule, Vincent, Blanchart, Katrien, Humbert, Xavier, Legallois, Damien, Lemaitre, Adrien, Milliez, Paul, Beygui, Farzin, Alexandre, Joachim
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - blood
Acute Coronary Syndrome - drug therapy
Acute Coronary Syndrome - epidemiology
Acute coronary syndromes
Age
Aged
Aged, 80 and over
Aspirin
Bleeding
Cardiology
Clinical trials
Comorbidity
Complications
Dose-Response Relationship, Drug
Drug dosages
Fibrinolytic Agents - administration & dosage
Fibrinolytic Agents - adverse effects
Fibrinolytic Agents - therapeutic use
Geriatrics
Guidelines
Heart attacks
Hemorrhage - chemically induced
Hemorrhage - prevention & control
Humans
Malnutrition
Medicine
Medicine & Public Health
Mortality
Myocardial infarction
Older people
Patients
Practice Guidelines as Topic
Renal function
Review Article
Stroke
Therapy
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Summary:Background Patients over 75 account for more than one third of those presenting with myocardial infarction and more than 50% of intrahospital mortality. There are no specific guidelines for the management of acute coronary syndromes (ACS) in the elderly. Setting Although antithrombotic therapy seems to be effective and safe in such patients, it requires specific precautions and treatment adjustments because of the higher bleeding risk due to comorbidities such as renal function impairment and malnutrition. Results Scientific evidence concerning elderly patients is scarce as they are either excluded or underrepresented in most randomized trials. Overall, the antithrombotic therapy needs to be adapted to avoid complications, mainly bleeding complications, without compromising the effectiveness of the treatment in this high-risk population. Conclusion In the present paper, we review the current treatment strategies in ACS while focusing on data concerning the elderly, according to available data in pivotal trials and in both AHA/ACC and ESC guidelines.
ISSN:0920-3206
1573-7241
DOI:10.1007/s10557-017-6761-y