Treatment of non-ST-elevation acute coronary syndrome in the elderly: current practice and future opportunities

The care of elderly patients with non-ST-elevation acute coronary syndrome is challenging, given the wide variability in physiologic condition and preferences among this patient group. Due to a higher burden of comorbidity, the elderly face high risks for death and complications from non-ST-elevation acute coronary syndrome relative to younger patients. Accordingly, they also have greater potential benefits from effective therapies. Antithrombotic therapy, invasive cardiac care, lipid lowering, and prevention advice, however, are all used less often in the elderly, even when no contraindications exist. Attention to individualized dosing and safety monitoring is also important for elderly patients. Increased awareness of the beneficial impact of therapies on outcomes in the elderly, along with vigilance for adverse events, should enable care to move from the state of uncertainty to opportunity in this high-risk population.