Hearts and bodies change with age, heartdisease treatments may need to change, too HeartNews CircAHA
confirmed that the majority of the benefit from the invasive strategy originated from data in trials published after 1999 and for patients with positive troponins or cardiac biomarkers. In addition, the significant benefit was seen in reduction of the combined end point of death or MI, with a trend to reduction in death.
The suggested approach to further investigation is as follows: First, reporting of safety and efficacy results by age subgroup will help clarify the balance of risk and benefit in the elderly. In certain instances, prospective trials performed exclusively in the elderly may be warranted. In addition, understanding geriatric syndromes as they overlap with ACS will help place therapeutic risks and benefits within the global health context of the elderly at highest risk.
Results should be reported for age subgroups such that absolute and relative risk reductions can be determined and tested for age interaction. Registries should monitor use of treatment in the elderly and should surveil for potential harm in elderly subgroups, particularly when trials have insufficient data to evaluate safety.Modifiers of risks and benefits in the elderly are multiple. Frail or cognitively impaired elderly should be identified in registry and trial populations. This would further our under-standing of the overlap between geriatric syndromes and the presentation and outcomes after ACS.
The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.
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