Reperfusion treatment in acute myocardial infarction in elderly patients.

Reperfusion treatment in acute myocardial infarction in elderly patients. Kardiol Pol. 2018 Apr 10;: Authors: Van de Werf F Abstract In this paper our current knowledge of reperfusion therapy in elderly patients with an ST-segment elevation acute myocardial infarction (STEMI) is summarised. Placebo-controlled trials of fibrinolytic agents, direct comparative trials of fibrinolytic agents and antithrombotic co-therapies, and randomised trials of primary percutaneous coronary intervention (PCI) versus fibrinolytic therapy as well as registries are briefly reviewed, focusing on the impact of age. The benefit and risk of a combined pharmacological and mechanical approach is presented. Important differences between a "facilitated PCI" and a "pharmaco-invasive strategy", in particular in older STEMI patients, are highlighted. It will become clear at the end of this review that our knowledge about the benefit and risk of reperfusion therapy in the elderly is still incomplete and that more clinical trials in the elderly are needed. Practical recommendations for elderly patients with STEMI based on our current knowledge have been provided. PMID: 29633231 [PubMed - as supplied by publisher]
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research