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.
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.
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.
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.