Document Detail

Which strategy should be used for acute ST-elevation myocardial infarction in patients aged more than 75 years?
MedLine Citation:
PMID:  16721199     Owner:  NLM     Status:  MEDLINE    
The optimal management of acute myocardial infarction in elderly people (>or= 75 years) is controversial because elderly patients have been excluded or are under-represented in most acute myocardial infarction trials. Randomized studies show that, also in the elderly, thrombolytic therapy is effective in reducing mortality after acute myocardial infarction but the benefit in terms of mortality, recurrent infarction and stroke is smaller compared to primary percutaneous coronary intervention. Among the available mechanical therapeutic strategies, stenting is found to be superior to balloon angioplasty, whereas the role of drug-eluting stents in this setting still remains to be evaluated. The standard use of intravenous unfractionated heparin is still recommended because of the increased risk of intracranial haemorrhage by a combination of low molecular weight heparin or IIb/IIIa inhibitors and thrombolytic agents. Dedicated randomized clinical trials are needed to establish the best reperfusion therapy for this expanding population, especially in patients admitted to hospitals without percutaneous coronary intervention facilities and in patients developing cardiogenic shock.
Alessio La Manna; Omer Goktekin; Damiana Fiscella; Miles Dalby; Jun Tanigawa; Antonio Fiscella; Corrado Tamburino; Carlo Di Mario
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  7     ISSN:  1558-2027     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-07-12     Completed Date:  2006-10-26     Revised Date:  2009-05-28    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  388-96     Citation Subset:  IM    
Division of Cardiology, Ferrarotto Hospital, University of Catania, Italy.
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MeSH Terms
Angioplasty / methods
Anticoagulants / therapeutic use
Fibrinolytic Agents / therapeutic use
Myocardial Infarction / therapy*
Patient Transfer
Thrombolytic Therapy
Reg. No./Substance:
0/Anticoagulants; 0/Fibrinolytic Agents

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