El tratamiento de síndromes coronarios agudos de ancianos y pacientes con comorbilidades

Translated title of the contribution: Treatment of acute coronary syndromes in the elderly and in patients with comorbidities

Stefano Savonitto, Nuccia Morici, Stefano De Servi

Research output: Contribution to journalArticlepeer-review

Abstract

Acute coronary syndromes have a wide spectrum of clinical presentations and risk of adverse outcomes. A distinction should be made between treatable (extent of ischemia, severity of coronary disease and acute hemodynamic deterioration) and untreatable risk (advanced age, prior myocardial damage, chronic kidney dysfunction, other comorbidities). Most of the patients with «untreatable» risk have been excluded from the «guideline- generating» clinical trials. In recent years, despite the paucity of specific randomized trials, major advances have been completed in the management of elderly patients and patients with comorbidities: from therapeutic nihilism to careful titration of antithrombotic agents, a shift toward the radial approach to percutaneous coronary interventions, and also to less-invasive cardiac surgery. Further advances should be expected from the development of drug regimens suitable for use in the elderly and in patients with renal dysfunction, from a systematic multidisciplinary approach to the management of patents with diabetes mellitus and anemia, and from the courage to undertake randomized trials involving these high-risk populations. Full English text available from: www.revespcardiol.org/en.

Translated title of the contributionTreatment of acute coronary syndromes in the elderly and in patients with comorbidities
Original languageSpanish
Pages (from-to)564-573
Number of pages10
JournalRevista Espanola de Cardiologia
Volume67
Issue number7
DOIs
Publication statusPublished - 2014

Keywords

  • Anemia
  • Diabetes mellitus
  • Kidney
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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