Bleeding Risk in Elderly Patients Undergoing Percutaneous Coronary Intervention: A Comprehensive Review

Area of Science:

• Cardiology
• Geriatrics
• Interventional Cardiology

Background:

• Aging populations are increasing the prevalence of coronary artery disease (CAD) requiring percutaneous coronary interventions (PCIs).
• Elderly patients undergoing PCI face heightened risks of ischemic and bleeding complications due to age-related physiological changes.
• Balancing antithrombotic benefits against bleeding risks in older adults is a significant clinical challenge.

Purpose of the Study:

• To review the epidemiological, pathophysiological, and clinical aspects of CAD in elderly patients undergoing PCI.
• To evaluate the effectiveness and limitations of current risk stratification tools in older populations.
• To identify strategies for optimizing personalized care and improving outcomes for elderly CAD patients.

Main Methods:

• Literature review synthesizing data on aging, CAD, PCI, and antiplatelet therapy.
• Assessment of existing risk stratification tools (e.g., PRECISE-DAPT, ARC-HBR) in the context of elderly patients.
• Analysis of age-related physiological factors influencing treatment decisions.

Main Results:

• Advanced age is associated with increased susceptibility to both thrombotic and bleeding events post-PCI.
• Current risk stratification tools may have limited predictive accuracy in elderly populations.
• Personalized antiplatelet therapy strategies are crucial but require further investigation.

Conclusions:

• Managing elderly patients with CAD post-PCI necessitates a nuanced approach considering unique age-related risks.
• Improved risk assessment tools tailored for older adults are needed to guide antiplatelet therapy.
• Optimizing personalized care is essential for enhancing outcomes in this vulnerable patient group.