TY - JOUR
T1 - Documento di posizione della Societá Italiana di Cardiologia Interventistica (SICI-GISE)
T2 - terapia antitrombotica nel paziente anziano con sindrome coronarica acuta
AU - Tarantini, Giuseppe
AU - Berti, Sergio
AU - De Luca, Leonardo
AU - De Servi, Stefano
AU - Favero, Luca
AU - Ferlini, Marco
AU - La Manna, Alessio
AU - Marchese, Alfredo
AU - Mauro, Ciro
AU - Menozzi, Alberto
AU - Mojoli, Marco
AU - Paradies, Valeria
AU - Varbella, Ferdinando
AU - Musumeci, Giuseppe
PY - 2016/1/1
Y1 - 2016/1/1
N2 - With the ageing of the population in the Western world, an increasing proportion of patients seen in cardiology practice is represented by the elderly. Although approximately one third of patients admitted with acute coronary syndrome (ACS) are >75 years old and the mortality rate in this age group is doubled compared with younger patients, this population is underrepresented in randomized controlled trials and, consequently, clinical guidelines do not always provide clear indications for the management of elderly patients. Therefore, there is an unmet need for clinical guidance regarding this rapidly growing subset of ACS patients, also considering that decisions about optimal antithrombotic treatment strategies in the elderly are often challenging, mostly due to age-related organ dysfunction, the frequency of comorbidities and concomitant medications and an increased risk of both ischemic and bleeding events. A panel of Italian cardiology experts assembled under the auspices of the Italian Society of Interventional Cardiology (SICI-GISE) for comprehensive discussion and consensus development, with the aim to provide practical recommendations, for both clinical and interventional cardiologists, regarding optimal management of antithrombotic therapy in patients with ACS aged 75 years. In this position paper, various clinical scenarios in patients with ST-elevation and non-ST-elevation myocardial infarction or unstable angina are presented and discussed, including special subsets (e.g., patients aged ≤ 85 years, patients with chronic renal disease or previous cerebrovascular events, patients requiring triple therapy or long-term antithrombotic therapy), with the panel's recommendations being provided for each scenario.
AB - With the ageing of the population in the Western world, an increasing proportion of patients seen in cardiology practice is represented by the elderly. Although approximately one third of patients admitted with acute coronary syndrome (ACS) are >75 years old and the mortality rate in this age group is doubled compared with younger patients, this population is underrepresented in randomized controlled trials and, consequently, clinical guidelines do not always provide clear indications for the management of elderly patients. Therefore, there is an unmet need for clinical guidance regarding this rapidly growing subset of ACS patients, also considering that decisions about optimal antithrombotic treatment strategies in the elderly are often challenging, mostly due to age-related organ dysfunction, the frequency of comorbidities and concomitant medications and an increased risk of both ischemic and bleeding events. A panel of Italian cardiology experts assembled under the auspices of the Italian Society of Interventional Cardiology (SICI-GISE) for comprehensive discussion and consensus development, with the aim to provide practical recommendations, for both clinical and interventional cardiologists, regarding optimal management of antithrombotic therapy in patients with ACS aged 75 years. In this position paper, various clinical scenarios in patients with ST-elevation and non-ST-elevation myocardial infarction or unstable angina are presented and discussed, including special subsets (e.g., patients aged ≤ 85 years, patients with chronic renal disease or previous cerebrovascular events, patients requiring triple therapy or long-term antithrombotic therapy), with the panel's recommendations being provided for each scenario.
KW - Acute coronary syndrome
KW - Antithrombotic therapy
KW - Elderly
KW - Octogenarians
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U2 - 10.1714/2140.23198
DO - 10.1714/2140.23198
M3 - Articolo
C2 - 26901262
AN - SCOPUS:84960931201
VL - 17
SP - 64
EP - 79
JO - Giornale Italiano di Cardiologia
JF - Giornale Italiano di Cardiologia
SN - 1827-6806
IS - 1
ER -