[Acute coronary syndrome: guidelines and geriatrics specificity]

Area of Science:

• Cardiology
• Geriatrics

Context:

• Acute coronary syndrome (ACS) is prevalent in the elderly, with high morbidity and mortality.
• Older adults are often underrepresented in clinical trials, leading to a lack of specific treatment guidelines.
• Geriatricians face challenges managing ACS in elderly patients without established protocols.

Purpose:

• To highlight the increased frequency and severity of ACS in the elderly population.
• To emphasize the need for tailored management strategies for older adults with ACS.
• To advocate for considering quality of life and physical condition alongside biological age in treatment decisions.

Summary:

• ACS encompasses unstable angina, NSTEMI, and STEMI, disproportionately affecting the elderly.
• Despite high complication risks, older individuals can benefit significantly from aggressive coronary revascularization.
• Treatment decisions for invasive procedures should integrate functional status and quality of life, not solely chronological or biological age.

Impact:

• Informs geriatricians and cardiologists on managing ACS in older patients.
• Promotes a more individualized approach to invasive cardiac procedures for the elderly.
• Aims to improve outcomes and quality of life for elderly ACS patients by challenging age-based exclusions from treatment.