Treatment For Coronary Artery Disease In Elderly

Coronary bypass grafting in selected patients clearly prolongs survival but careful patient selection and meticulous. Most of the landmark clinical trials that have led to important changes in management of coronary disease eg.

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Unfortunately most elderly patients have high-risk or severe coronary artery disease.

Treatment for coronary artery disease in elderly. Antithrombotic Management of Elderly Patients With Coronary Artery Disease. However the elderly population is also more vulnerable to bleeding complications. Most elderly patients will require a loop diuretic because of the age related and.

Management of Coronary Artery Disease in the Elderly Coronary artery disease may be managed using medical therapy or techniques such as percutaneous coronary intervention PCI. Those with non-Q-wave infarctions hypertension recent stroke history of bleeding or other contraindications are not candidates. Treatment of elderly patients aged 60 years with pravastatin with average cholesterol levels total cholesterol 209 17 mgdL high-density lipoprotein 39 9 mgdL LDL 139 15 mgdL in the Cholesterol and Recurrent Events CARE trial revealed a 27 relative risk reduction compared with placebo and a 26 relative risk reduction compared with patients aged younger than 60 years.

3 Treating high blood pressure in older adults is a challenge due to other comorbid conditions frailty cognitive impairment and multiple medication use. Lowering blood pressure can be done safely with an established monitored medication regime physical activity and reduced sodiumsalt intake. It is important to reemphasize that this recommendation is for treating elderly patients with acute infarction as suggested by ST-segment elevation andor Q waves without contraindications to thrombolytic therapy.

However many patients and their doctors feel that the effect of treatment on life expectancy becomes less important as the individual gets older. Balloon dilatation can yield excellent results in certain highly selected high-risk patients but its role in the frequently encountered multivessel disease patient is unclear until current studies are completed. As in younger patients prolongation of survival should not be the exclusive goal.

Long-term survival and pain relief after coronary artery bypass grafting are excellent in older patients and percutaneous transluminal coronary angioplasty may be the treatment of choice in some elderly patients with coronary artery disease. Evidence from epidemiologic studies indicates that the same factors that are associated with increased risk of coronary heart disease CHD in middle-aged people are relevant in older. Antithrombotic therapy represents the mainstay of treatment in patients with coronary artery disease CAD including elderly patients who are at increased risk for ischemic recurrences.

Both objec-tives are important at any age. Recent advances in the treatment of stable angina have shown that use of angiotensin-converting enzyme inhibitors and lipid-lowering therapy as adjunctive measures show benefit in the elderly by reducing the occurrence of death nonfatal myocardial infarction and unstable angina. For STEMI patients mechanical revascularization with percutaneous coronary intervention PCI within 90 minutes remains the standard of care especially given the increased bleeding risk associated with thrombolysis at elderly age.

However logistical impediments associated with revascularization escalate as a function of age. The management of systolic heart failure in elderly patients as in younger patients involves the use of diuretics vasodilators and oxygen supplementation table 1. A CASE REPORT Coronary artery fistulas are congenital or acquired abnormality connections between.

Older people with coronary artery disease may be prescribed beta blockers but doctors have to be really careful with patients who have diabetes that requires insulin shots. Only limited long-term data are available on the use of either dihydropyridine calcium channel blockers other than nitrendipine or nondihydropyridine calcium channel blockers in. The 4S study of lipid-lowering.

Download Citation CORONARY ARTERY FISTULA IN ELDERLY PATIENT WITH ACUTE CORONARY SYNDROME. Ment in coronary artery disease. Calcium channel blockers might also be a good treatment but verapamil and.

Stable Coronary Artery Disease Treatment American Family Physician