Management of Acute Coronary Syndrome in the Older Adult Population

Published: December 12, 2022

elderly hands holding onto heart shaped stress ball
  • Coronary artery disease (CAD) and acute coronary syndrome (ACS) disproportionately affect adults > 75 yrs old which is significant because older adults have both greater comorbidity burden and greater complexity of coronary artery disease.
  • Geriatric syndromes which include multimorbidity with resultant polypharmacy, frailty, cognitive impairment, and delirium complicate the presentation, assessment, and management of ACS and are associated with worsened outcomes from ACS.
  • This statement reviews age related physiologic changes that predispose ACS and management complexity, describes the influence of commonly encountered geriatric syndromes on cardiovascular outcomes, and offers age-appropriate and guideline-concordant revascularization and ACS management strategies, including transitions of care, the use of cardiac rehabilitation, palliative care services, and holistic approaches.