Interventional therapy indications in the elderly - are they different?

GÜNERİ S.

TURK KARDIYOLOJI DERNEGI ARSIVI-ARCHIVES OF THE TURKISH SOCIETY OF CARDIOLOGY, vol.45, pp.39-41, 2017 (ESCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 45
  • Publication Date: 2017
  • Doi Number: 10.5543/tkda.2017.99165
  • Journal Name: TURK KARDIYOLOJI DERNEGI ARSIVI-ARCHIVES OF THE TURKISH SOCIETY OF CARDIOLOGY
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.39-41
  • Keywords: Percutanous coronary intervention, elderly, ELEVATION MYOCARDIAL-INFARCTION, PERCUTANEOUS CORONARY INTERVENTION, GREATER-THAN-OR-EQUAL-TO-75 YEARS, UNSTABLE ANGINA, TERM OUTCOMES, AGE, STENTS, OLDER, STRATEGY, SURGERY
  • Dokuz Eylül University Affiliated: Yes

Abstract

The prevalance of cardiovascular disease increases with age and cardiovascular disease is the leading cause of death in adults >75 years of age. However many trials have excluded older patients. So we don't have randomized trials but only limited subgroup analysis or registries for older patients. In general the indications for intervention and revascularization are not different in elderly patients. But complex co-morbidities, significant physical or cognitive disabilities can change our decision. Complex Coronary anatomy and the complications of the procedure is high in older patients. Long term mortality is similar in patients treated with Coronary artery bypass graft surgery or percutaneous coronary intervention, but re-intervention is higher in coronary intervention group. Invazive approach is superior to conservative treatment even in very elderly patients with acute coronary syndrome. We need randomized trials including mainly older patients in this era.