July 1, 2017Open Access
Antithrombotic treatment tailoring and risk score evaluation in elderly patients diagnosed with an acute coronary syndrome.
Key result
The GRACE risk score is extensively validated in elderly patients with acute coronary syndromes, whereas the CRUSADE bleeding score has only a moderate correlation with outcomes.
Why the study?
How do current ischemic and bleeding risk scores perform in elderly patients with ACS, and what is the optimal antithrombotic regimen?
Population
Elderly patients (>75 years old) diagnosed with an acute coronary syndrome (ACS)
Design
Review
Authors
Discussion
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Implication
GRACE score validated for elderly ACS ischemic risk; CRUSADE shows only moderate correlation, leaving frailty integration open for prospective study.
Structured PICO
How do current ischemic and bleeding risk scores perform in elderly patients with ACS, and what is the optimal antithrombotic regimen?
P
Population
Elderly patients (>75 years) diagnosed with acute coronary syndromes.
E
Exposure
Antithrombotic and antiplatelet pharmacotherapy; risk score evaluation (GRACE, CRUSADE, frailty)
O
Outcome
Ischemic and bleeding risk prediction accuracy; optimal pharmacological regimen efficacy and safety
In elderly patients with ACS, the GRACE score is well-validated for risk stratification, but bleeding scores like CRUSADE have only moderate correlation, highlighting the need to integrate frailty scores for optimal antithrombotic tailoring.
Limitations
- Lack of head-to-head scores that quantify ischemic versus hemorrhagic risk
- Lack of scores that use the same end point and timeline
Cite This Study
Mischie et al. (2017) conducted a review in Acute coronary syndrome. Risk score evaluation (GRACE, CRUSADE) and antithrombotic treatment was evaluated. The GRACE risk score is extensively validated in elderly patients with acute coronary syndromes, whereas the CRUSADE bleeding score has only a moderate correlation with outcomes.