Trattamento delle sindromi coronariche acute nel paziente anziano: Insegnamenti dell'Italian Elderly ACS Study

Translated title of the contribution: Treatment of acute coronary syndromes in elderly patients: Lessons of the Italian Elderly ACS Study

Stefano Savonitto, Roberto Antonicelli, Daniele Caraceni, Fabrizio D'Ambrosi, Stefano De Servi

Research output: Contribution to journalArticlepeer-review

Abstract

Elderly patients account for one third of those admitted to cardiac care units with non-ST-elevation acute coronary syndromes, but are largely underrepresented in randomized clinical trials which form the basis of practice guidelines. Conducting trials in this patient population is especially difficult due to coexisting pathologies, informed consent issues, a perceived higher risk of interventional procedures, and complexity of follow-up. The Italian Elderly ACS Study has been a positive experience in terms of accepting this challenge, carrying it on with limited resources and delineating convincing results, although not statistically conclusive due to its final limited sample size. The indications from the study are straightforward in patients with elevated troponin levels on admission and other high-risk characteristics: in these patients, an early invasive approach has reduced by 40% to 60% the risk of fatal and nonfatal ischemic complications at 1-year follow-up. This result has been achieved with an incidence of bleeding complications which was by far lower than previously reported in the literature, probably due to a systematic radial approach to vascular interventions and a cautious use of antithrombotic treatments in the acute phase.

Translated title of the contributionTreatment of acute coronary syndromes in elderly patients: Lessons of the Italian Elderly ACS Study
Original languageItalian
JournalGiornale Italiano di Cardiologia
Volume13
Issue number10 SUPPL.2
DOIs
Publication statusPublished - Oct 2012

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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