老年心脏病学杂志（英文版）2012，Vol.9Issue(2)：192-196,5.DOI:10.3724/SP.J.1263.2012.01312
Acute coronary syndromes: an old age problem
Acute coronary syndromes: an old age problem
Alexander D Simms 1Philip D Batin 2John Kurian 3Nigel Durham 4Christopher P Gale1
作者信息
- 1. Centre for Epidemiology and Biostatistics, Level 8, Worsley Building, University of Leeds, Clarendon Way, West Yorkshire, Leeds, LS2 9JT, UK
- 2. Department of Cardiology, Mid Yorkshire NHS Trust, Wakefield, WF1 4DG, UK
- 3. Department of Cardiology, Bradford Teaching Hospital NHS Foundation Trust, Bradford, UK
- 4. Department of Cardiology, York Teaching Hospital NHS Foundation Trust, York, YO31 8HE, UK
- 折叠
摘要
Abstract
The increasing population in older age will lead to greater numbers of them presenting with acute coronary syndromes (ACS). This has implications on global healthcare resources and necessitates better management and selection for evidenced-based therapies. The elderly are a high risk group with more significant treatment benefits than younger ACS. Nevertheless, age related inequalities in ACS care are recognised and persist. This discrepancy in care, to some extent, is explained by the higher frequency of atypical and delayed presentations in the elderly, and less diagnostic electrocardiograms at presentation, potentiating a delay in ACS diagnosis. Under estimation of mortality risk in the elderly due to limited consideration for physiological frailty, co-morbidity, cognitive/psychological impairment and physical disability, less input by cardiology specialists and lack of randomised, controlled trials data to guide management in the elderly may further confound the inequality of care. While these inequalities exist, there remains a substantial opportunity to improve age related ACS outcomes. The selection of elderly patients for specific therapies and medication regimens are unanswered. There is a growing need for randomised, controlled trial data to be more representative of the population and enroll those of advanced age with co-morbidity. A lack of reporting of adverse events, such as renal impairment post coronary angiography, in the elderly further limit risk benefit decisions. Substantial improvements in care of elderly ACS patients are required and should be advocated. Ultimately, these improvements are likely to lead to better outcomes post ACS. However, the improvement in outcome is not infinite and will be limited by non-modifiable factors of age-related risk. 关键词
Acute coronary syndromes/ Elderly patients/ Inequalities of care/ Evidenced-based treatments Key words
Acute coronary syndromes/ Elderly patients/ Inequalities of care/ Evidenced-based treatments 引用本文复制引用
Alexander D Simms,Philip D Batin,John Kurian,Nigel Durham,Christopher P Gale..Acute coronary syndromes: an old age problem [J].老年心脏病学杂志（英文版）,2012,9(2):192-196,5.
