Key result
A review of contemporary care for older patients with acute coronary syndrome reveals a lack of robust evidence for medical and percutaneous management, necessitating large-scale randomized trials.
Why the study?
Older patients have higher mortality after acute coronary syndrome but are less likely to receive evidence-based care, and guideline recommendations are often derived from trials that excluded them.
Is the contemporary care of older persons with acute coronary syndrome evidence-based?
Is the contemporary care of older persons with acute coronary syndrome evidence-based?
There is a significant evidence gap in the management of older patients with ACS, necessitating their inclusion in future large-scale randomized trials.
Evidence gaps preclude firm recommendations for older ACS patients; leaves open the urgent need for dedicated large-scale RCTs.
Globally, ischaemic heart disease is the leading cause of death, with a higher mortality burden amongst older adults. Although advancing age is associated with a higher risk of adverse outcomes following acute coronary syndrome (ACS), older patients are less likely to receive evidence-based medications and coronary angiography. Guideline recommendations for managing ACS are often based on studies that exclude older patients, and more contemporary trials have been underpowered and produced inconsistent findings. There is also limited evidence for how frailty and comorbidity should influence management decisions. This review focuses on the current evidence base for the medical and percutaneous management of ACS in older patients and highlights the distinct need to enrol older patients with ACS into well-powered, large-scale randomized trials.
No takes yet. Share an insight, caveat, or question.
Mills et al. (2021) conducted a review in Acute coronary syndrome. Medical and percutaneous management was evaluated. A review of contemporary care for older patients with acute coronary syndrome reveals a lack of robust evidence for medical and percutaneous management, necessitating large-scale randomized trials.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: