Managing acute coronary syndrome: Protocols and best practices

Background: Acute Coronary Syndrome (ACS) management in elderly patients poses unique challenges due to age-related physiological changes and comorbidities. Prompt and accurate assessment and management are crucial to prevent adverse outcomes. Aim: This review aims to evaluate current protocols and best practices for managing ACS in elderly patients, focusing on diagnostic strategies, treatment options, and considerations for invasive and antithrombotic therapies. Review also aimed to improve the future responses via pharmacists, emergency services, and health information systems. Methods: The review synthesizes guidelines and recent research on the management of ACS in elderly populations. It highlights the importance of early ECG interpretation, risk assessment, and tailored therapeutic interventions, including antithrombotic therapies and invasive procedures. Results: Key findings include the necessity for early and precise diagnostic evaluation, including ECG and troponin tests. Invasive management strategies, such as early coronary angiography, have shown benefits but must be carefully weighed against risks in very elderly patients. Antithrombotic therapy requires dose adjustments based on renal function and bleeding risks. Radial access is preferred during PCI to minimize bleeding complications. The review also discusses ongoing research in optimizing antithrombotic therapies for the elderly.