ISSN 1671-5411 CN 11-5329/R
Sergio García-Blas, Clara Bonanad, Juan Sanchis. Invasive strategy in elderly patients with acute coronary syndrome in 2018: close to the truth?. J Geriatr Cardiol 2019; 16(2): 114-120. doi: 10.11909/j.issn.1671-5411.2019.02.004
Citation: Sergio García-Blas, Clara Bonanad, Juan Sanchis. Invasive strategy in elderly patients with acute coronary syndrome in 2018: close to the truth?. J Geriatr Cardiol 2019; 16(2): 114-120. doi: 10.11909/j.issn.1671-5411.2019.02.004

Invasive strategy in elderly patients with acute coronary syndrome in 2018: close to the truth?

doi: 10.11909/j.issn.1671-5411.2019.02.004
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This work was supported by grants from Spain’s Ministry of Economy and Competitiveness through the Carlos III Health Institute: FIS 17/01736, FIS 17/00899 and FIS 15/00837, FEDER; CIBER-CV 16/11/00420, Madrid, Spain. The study was also funded by Generalitat Valenciana (Exp. GV/2018/116).

  • Received Date: 2019-01-16
  • Rev Recd Date: 2019-02-24
  • Publish Date: 2019-02-28
  • Elderly population constitutes an increasingly larger proportion of patients admitted for acute coronary syndromes (ACS). The optimal management of ACS in these patients is still a challenge due to their clinical peculiarities and the paucity of specific data, and they have been traditionally managed more conservatively mainly based on subjective criteria. In ST-segment elevation acute myocardial infarction urgent reperfusion is the standard of care and there is no upper age limit. In non-ST segment elevation acute myocardial infarction evidence is controversial, incomplete and mainly focused on chronological age. While a strict conservative strategy should be avoided, routine invasive strategy may reduce the occurrence of myocardial infarction and need for revascularization at follow-up with no established benefit in terms of mortality. Clinical characteristics associated with aging, such as comorbidities and frailty, further discriminate patient’s risk beyond age. Evidence is scarce, but it suggests that these features may modulate the benefit of invasive strategy in this population. Ongoing trials should clarify the optimal management of ACS based on these parameters.
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