Management of Acute Coronary Syndrome in the Older Adult Population
Published: December 12, 2022
- 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.
Supporting Materials
- Commentary: Cardiovascular Aging and Acute Coronary Syndromes: Unique Challenges and Solutions for Our Elderly Patients by Devika Kir, MBBS; Rajiv Gulati, MD, PhD and Mauricio G. Cohen, MD
- Top Things to Know: Management of ACS in the Older Adult Population
- Commentary: The Management of ACS in Older Patients: Is Age Just a Number? by Jennifer A. Rymer, MD, MBA, MHS and L. Kristin Newby, MD
Recommended Reading
- 2021 Guideline for the Evaluation and Diagnosis of Chest Pain
- 2021 Guideline for Coronary Artery Revascularization
- 2019 Older Adults in the Cardiac Intensive Care Unit: Factoring Geriatric Syndromes in the Management, Prognosis, and Process of Care
- 2019 Cardiorenal Syndrome: Classification, Pathophysiology, Diagnosis, and Treatment Strategies
- 2018 Guideline on the Management of Blood Cholesterol
- 2017 Prioritizing Functional Capacity as a Principal End Point for Therapies Oriented to Older Adults With Cardiovascular Disease
- 2015 Pharmacotherapy in Chronic Kidney Disease Patients Presenting With Acute Coronary Syndrome