Optimal dual antiplatelet therapy strategy in elderly patients with acute coronary syndrome

Monica Verdoia; Rocco Gioscia; Giuseppe De Luca

doi:10.11909/j.issn.1671-5411.2021.03.010

Volume 18 Issue 3

Mar. 2021

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Please cite this article as: M Verdoia, R Gioscia, G D Luca. Optimal dual antiplatelet therapy strategy in elderly patients with acute coronary syndrome. J Geriatr Cardiol 2021; 18(3): 210−218. DOI: 10.11909/j.issn.1671-5411.2021.03.010

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Please cite this article as: M Verdoia, R Gioscia, G D Luca. Optimal dual antiplatelet therapy strategy in elderly patients with acute coronary syndrome. J Geriatr Cardiol 2021; 18(3): 210−218. DOI: 10.11909/j.issn.1671-5411.2021.03.010

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Optimal dual antiplatelet therapy strategy in elderly patients with acute coronary syndrome

doi: 10.11909/j.issn.1671-5411.2021.03.010

1.
Cardiologia e Unità Coronarica, Ospedale degli Infermi, ASL Biella, Italy; Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, Università del Piemonte Orientale, Novara, Italy

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Corresponding author: giuseppe.deluca@maggioreosp.novara.it
Available Online: 2021-04-07
Publish Date: 2021-03-31

Abstract

Abstract

One out of three hospitalizations for acute coronary syndrome (ACS) involve nowadays elderly patients, carrying together a significant burden of comorbidities and a higher risk of complications. In particular, both ischemic and haemorrhagic risk are markedly enhanced in advanced age, and strictly interconnected, challenging the management of dual antiplatelet therapy (DAPT) in these patients. The recent development of several therapeutic options in terms of duration and combination of antiplatelet agents have offered a wider spectrum of opportunities for a more individualized approach in the management of DAPT after an ACS, although the criteria for the selection of the most appropriate strategy in each patient still lack validation. In particular, dose-adjustment, early aspirin discontinuation, laboratory-driven tailoring and shorter or extended DAPT have been addressed with promising safety and efficacy results. The present review provides an updated overview on the emerging evidencefrom randomized clinical trials and subanalyses dedicated to the management of DAPT in elderly patients presenting with ACS.

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References(56)

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