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Acute Coronary Syndrome IV: Interprofessional Care01:28

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IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
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Coronary Artery Disease V: Interprofessional Care01:27

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Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
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Acute Coronary Syndrome III: Diagnostic Studies01:30

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Acute Coronary Syndrome V: Nursing Management01:26

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Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
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Acute Coronary Syndrome I: Introduction01:30

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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Revascularization in Patients Over 75 With Acute Coronary Syndrome.

Samantha Pozo Navarro1, Kendall Hammonds2, Timothy Mixon3

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The American Journal of Cardiology
|December 14, 2025
PubMed
Summary

Coronary artery bypass grafting (CABG) shows improved outcomes for acute coronary syndromes (ACS) and multivessel coronary artery disease (MV-CAD) in patients over 75. CABG is a safe and effective revascularization strategy across age groups.

Keywords:
ACSCABGPCIelderlymedical managementmultivessel disease

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Cardiology

Background:

  • Observational data suggest coronary artery bypass graft (CABG) improves outcomes for acute coronary syndromes (ACS) with multivessel coronary artery disease (MV-CAD) compared to percutaneous coronary intervention (PCI) or medical management (MM).
  • Limited research exists on the efficacy of these revascularization strategies in patients aged 75 and older.

Purpose of the Study:

  • To compare the 1-year outcomes of CABG, PCI, and MM in patients with ACS and MV-CAD.
  • To stratify outcomes based on age groups: <75 years and ≥75 years.
  • To evaluate the impact of age on mortality and other clinical endpoints following revascularization.

Main Methods:

  • Retrospective, multi-centered observational study from 2018-2022.
  • Inclusion criteria: patients with ACS and MV-CAD.
  • Primary endpoint: 1-year mortality. Secondary endpoints: readmission, myocardial infarction (MI), length of stay, repeat revascularization. Cox proportional hazards modeling used.

Main Results:

  • A total of 2161 patients were analyzed (1559 CABG, 295 PCI, 307 MM).
  • Patients aged ≥75 (n=614) showed similar outcomes to those <75 (n=1547).
  • CABG was associated with significantly reduced mortality compared to PCI or MM (RR = 0.324, p <0.0001) across both age groups.

Conclusions:

  • Coronary artery bypass graft (CABG) is associated with improved and comparable outcomes in patients with acute coronary syndromes (ACS) and multivessel coronary artery disease (MV-CAD).
  • This benefit extends to patients aged 75 and older, suggesting CABG is a viable revascularization strategy for this demographic.
  • Further research may explore long-term outcomes and quality of life differences between revascularization strategies in elderly populations.