接受PCI的老年人的评估和管理,第1部分:A JACC:进步 专家小组
Michael G Nanna1, Nadia R Sutton2,3, Ajar Kochar4
1Yale University School of Medicine, New Haven, Connecticut, USA.
JACC. Advances
|August 16, 2023
概括
接受心脏导管治疗的老年人面临高风险. 风险评估中应该添加第四个支柱,即老年综合征,以更好地识别将受益于手术的患者.
科学领域:
- 老年医学 老年医学
- 心脏病学 心脏病学
- 干预性心脏病学 干预性心脏病学
背景情况:
- 人口老龄化增加了对心脏导管实验室的转诊.
- 老年人患病和死亡风险最高,特别是在高风险的皮肤冠状动脉干预后.
- 目前的风险评估工具可能无法充分捕捉这一群体的风险.
研究的目的:
- 突出老年综合征在接受心脏导管治疗的老年人风险评估中的重要性.
- 提出一个扩展的风险评估框架,包括老年医疗领域.
主要方法:
- 审查目前对心脏导管治疗的风险评估策略.
- 确定关键的老年综合征与心血管程序相关.
- 关于四个支柱风险评估模型的建议.
主要成果:
- 传统的风险评估依赖于心血管,生理,血液动力学和解剖/程序因素.
- 老年综合征在老年人中代表了一个关键的,经常被忽视的风险领域.
- 这些综合征可以显著影响结果,并可能取代其他危险因素.
结论:
- 对接受心脏导管治疗的老年人进行全面的风险评估必须包括老年综合征.
- 整合老年评估可以改善患者的选择和优化结果.
- 这种扩展的方法旨在通过考虑独特的老年人弱点来确保净收益.
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