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Antiplatelet therapy in very elderly and comorbid patients with acute coronary syndromes.

Authors :
De Rosa, Roberta
Piscione, Federico
Galasso, Gennaro
De Servi, Stefano
Savonitto, Stefano
Source :
Journal of Geriatric Cardiology; 2019, Vol. 16 Issue 2, p103-113, 11p
Publication Year :
2019

Abstract

With population ageing and rise of life expectancy, a progressively increasing proportion of patients presenting with an acute coronary syndrome (ACS) are older adults, including those at extreme chronological age. Increasing amounts of data, including randomized clinical trials, have shown that the benefits of an early revascularization are maintained also at very old age, resulting in improved outcome after an acute coronary event. On the contrary, the optimal antiplatelet therapy (APT) remains unclear in these patients, because of both safety and efficacy concerns. Indeed, age-related multiple organ dysfunction and high prevalence of comorbidities may on the one hand reduce the therapeutic effects of administered drugs; on the other hand, it leads to increased vulnerability to drug toxicity and side effects. Therefore, management of APT is particularly challenging in elderly patients because of higher risk of both ischemic and bleeding events. The aim of the present paper is to review the current evidence, gaps in knowledge and ongoing research regarding APT in the setting of an ACS in elderly and very elderly patients, and in those with significant comorbidities including chronic kidney disease, diabetes mellitus and frailty. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
16715411
Volume :
16
Issue :
2
Database :
Complementary Index
Journal :
Journal of Geriatric Cardiology
Publication Type :
Academic Journal
Accession number :
135761268
Full Text :
https://doi.org/10.11909/j.issn.1671-5411.2019.02.006