Document Detail

Treatment of acute coronary syndromes in the elderly and in patients with comorbidities.
MedLine Citation:
PMID:  24952397     Owner:  NLM     Status:  In-Data-Review    
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.
Stefano Savonitto; Nuccia Morici; Stefano De Servi
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Publication Detail:
Type:  Journal Article     Date:  2014-05-27
Journal Detail:
Title:  Revista española de cardiología (English ed.)     Volume:  67     ISSN:  1885-5857     ISO Abbreviation:  Rev Esp Cardiol (Engl Ed)     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-06-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101587954     Medline TA:  Rev Esp Cardiol (Engl Ed)     Country:  Spain    
Other Details:
Languages:  eng     Pagination:  564-73     Citation Subset:  IM    
Copyright Information:
Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.
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