Antithrombotic therapy in acute coronary syndrome: undertreatment of elderly?

Submitted: March 1, 2020
Accepted: April 22, 2020
Published: November 20, 2020
Abstract Views: 1012
PDF: 435
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

The appropriate use of dual antiplatelet therapy (DAPT) in elderly patients with acute coronary syndrome (ACS) is largely debated. Due to the "demographic transition" in western countries, the elderly represent a growing percentage of patients admitted to hospitals for ACS, and among this high risk setting population most of early and late adverse outcomes occur. The presence of several concomitant “comorbidities†complicate the management strategy of both medical or invasive treatment and the clinical decision making process is challenging. Moreover, elderly people are constantly underrepresented in clinical trials and studies. As a result, there is no specific evidence about the optimal antithrombotic therapy in elderly and no specific recommendations are mentioned in the current ACS guidelines. Currently, the best practice for old people is still rudimentary and principally extrapolated from general cardiovascular guidelines. The management of elderly patients should be based on the evaluation of ischemic and hemorrhagic risk, life expectancy, comorbidities and parameters that are not included in the scores recommended by the current guidelines such as frailty and disability. In the era of “precision medicineâ€, the evaluation of bleeding and ischaemic risk in elderly patients must be a dynamic process because of the risk changing over time. A“tailored therapy by individualized medicine†is the key of management strategy.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

How to Cite

Muraca, Iacopo, Francesca Ciatti, Angela Migliorini, Niccolò Marchionni, and Renato Valenti. 2020. “Antithrombotic Therapy in Acute Coronary Syndrome: Undertreatment of Elderly?”. Monaldi Archives for Chest Disease 90 (4). https://doi.org/10.4081/monaldi.2020.1261.

Similar Articles

<< < 52 53 54 55 56 57 58 59 60 61 > >> 

You may also start an advanced similarity search for this article.