The elderly are at high risk of acute coronary syndrome (ACS) but receive less cardiac medication and invasive care than other groups. Two factors may explain this: limited data from randomized clinical trials and uncertainty about benefit and risk with advancing age.
In two articles published recently in the journal Clinical Geriatrics, Dr. Brett Sheridan (right) and colleagues in the UNC School of Public Health, UNC Division of Cardiology, and Sheps Center for Health Services Research reviewed the use of therapies for ACS and the challenges of diagnosing and treating ACS in the elderly. They also examined outcomes results of invasive therapies (percutaneous coronary intervention and coronary artery bypass grafting).
Given the benefits observed in recent trials, age alone should not prevent consideration of invasive treatment of ACS in the elderly, but rather should intensify it, the group concluded.
The research was supported by an NIH R01 grant (Acute coronary syndrome outcomes in Medicare patients) on which Dr. Sheridan is co-principal investigator.
Read the articles:
Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting: Intervention in Older Persons with Acute Coronary Syndrome - Part I (Sheridan BC, Stearns SC, Massing MW, Stouffer GA, D'Arcy SP, Carey TS). Clinical Geriatrics 16(10):39-44, 2008.
Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting: Intervention in Older Persons with Acute Coronary Syndrome - Part II (Sheridan BC, Stearns SC, Massing MW, Stouffer GA, D'Arcy SP, Carey TS). Clinical Geriatrics 16(11):40-46, 2008.