Unstable angina / non ST elevation myocardial infarction elderly
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Overview of Elderly Patients with UA / NSTEMI
ACC / AHA Guidelines (DO NOT EDIT) [1]
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Class I1. Older patients with UA / NSTEMI should be evaluated for appropriate acute and long term therapeutic interventions in a similar manner as younger patients with UA / NSTEMI. (Level of Evidence: A) 2. Decisions on management of older patients with UA / NSTEMI should not be based solely on chronologic age but should be patient centered, with consideration given to general health, functional and cognitive status, comorbidities, life expectancy, and patient preferences and goals. (Level of Evidence: B) 3. Attention should be given to appropriate dosing (i.e., adjusted by weight and estimated creatinine clearance) of pharmacological agents in older patients with UA / NSTEMI, because they often have altered pharmacokinetics (due to reduced muscle mass, renal and/or hepatic dysfunction, and reduced volume of distribution) and pharmacodynamics (increased risks of hypotension and bleeding). (Level of Evidence: B) 4. Older UA / NSTEMI patients face increased early procedural risks with revascularization relative to younger patients, yet the overall benefits from invasive strategies are equal to or perhaps greater in older adults and are recommended. (Level of Evidence: B) 5. Consideration should be given to patient and family preferences, quality of life issues, end of life preferences, and sociocultural differences in older patients with UA / NSTEMI. (Level of Evidence: C) | ” |
See Also
Sources
- The ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction [1]
References
- ↑ 1.0 1.1 Anderson JL, Adams CD, Antman EM, et al (August 2007). "ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine". JACC 50 (7): e1–e157. PMID 17692738.
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