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Antiplatelet Therapy for Elderly Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Vincenzo Fioretti1,2, Luca Sperandeo2, Donato Gerardi1

  • 1Division of Cardiology, Cardiovascular Department, Azienda Ospedaliera Regionale "San Carlo", 85100 Potenza, Italy.

Journal of Clinical Medicine
|July 27, 2024
PubMed

Insights

Elderly patients with acute coronary syndrome (ACS) benefit from percutaneous coronary revascularization, but antiplatelet therapy is complex due to high risks of ischemia and bleeding. This review examines evidence for antiplatelet strategies in older ACS patients.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Elderly patients are a growing demographic for acute coronary syndrome (ACS).
  • Percutaneous coronary revascularization benefits are established in older ACS patients.
  • Antiplatelet therapy management in the elderly is challenging due to dual risks of ischemia and bleeding.

Purpose of the Study:

  • To review factors influencing ischemic and bleeding risks in elderly ACS patients.
  • To summarize evidence for antiplatelet strategies in this population undergoing percutaneous coronary revascularization.

Main Methods:

  • Literature review focusing on elderly patients with ACS.
  • Analysis of risk factors for ischemia and bleeding.
  • Evaluation of current and novel antiplatelet therapies.

Main Results:

  • Existing risk scores may not accurately reflect older patients' profiles.
  • Elderly patients often have limited representation in clinical trials for new antiplatelet agents.
  • Evidence for optimal antiplatelet strategies in this complex group is still evolving.

Conclusions:

  • Careful consideration of individual risk factors is crucial for managing antiplatelet therapy in elderly ACS patients.
  • Further research is needed to establish evidence-based antiplatelet guidelines for older adults undergoing percutaneous coronary revascularization.

Keywords:
acute coronary syndromeantiplateletselderlypercutaneous coronary intervention

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