July 1, 2023Open Access
A Geriatric Approach to Percutaneous Coronary Interventions in Older Adults, Part II
Key Result
A comprehensive geriatric risk assessment and a specialized geriatric heart team are proposed to optimize patient-centered outcomes in older adults undergoing percutaneous coronary interventions.
Structured PICO
P
Population
Older adults undergoing percutaneous coronary interventions
I
Intervention
Geriatric risk assessment approach and implementation of a "geriatric" heart team
Proposes the integration of geriatric principles and a specialized heart team to optimize patient-centered outcomes in older adults undergoing PCI.
Abstract
We review a comprehensive risk assessment approach for percutaneous coronary interventions in older adults and highlight the relevance of geriatric syndromes within that broader perspective to optimize patient-centered outcomes in interventional cardiology practice. Reflecting the influence of geriatric principles in older adults undergoing percutaneous coronary interventions, we propose a "geriatric" heart team to incorporate the expertise of geriatric specialists in addition to the traditional heart team members, facilitate uptake of the geriatric risk assessment into the preprocedural risk assessment, and address ways to mitigate these geriatric risks. We also address goals of care in older adults, highlighting common priorities that can impact shared decision making among older patients, as well as frequently encountered pharmacotherapeutic considerations in the older adult population. Finally, we clarify gaps in current knowledge and describe crucial areas for future investigation.