Tom 14, Nr 1 (2017)
Choroba wieńcowa
Opublikowany online: 2017-06-29
Wyświetlenia strony
742
Wyświetlenia/pobrania artykułu
6410
Ostry zespół wieńcowy u osób w podeszłym wieku
Choroby Serca i Naczyń 2017;14(1):15-23.
Streszczenie
Ryzyko zachorowania na ostry zespół wieńcowy (ACS) wyraźnie wzrasta z wiekiem, a leczenie u chorych w podeszłym wieku jest trudne i w wie-lu wypadkach kontrowersyjne. Ta grupa pacjentów ma niedostateczną reprezentację w badaniach randomizowanych, co w konsekwencji utrudnia podejmowanie decyzji klinicznych. Ponadto osoby starsze są częściej obciążone licznymi schorzeniami współistniejącymi, a tym samym stosowane leczenie wiąże się często z możliwością wystąpienia powikłań. W niniejszej pracy przedstawiono przegląd literatury opisującej zalecenia i możliwości leczenia AC S u starszych osób, a także trudności w jego stosowaniu oraz zagrożenia wynikające z obserwowanych powikłań.
Słowa kluczowe: ostry zespół wieńcowyrewaskularyzacjaprzewlekła choroba nerek
Referencje
- Gierlotka M, Zdrojewski T, Wojtyniak B, et al. Incidence, treatment, in-hospital mortality and one-year outcomes of acute myocardial infarction in Poland in 2009-2012--nationwide AMI-PL database. Kardiol Pol. 2015; 73(3): 142–158.
- Poloński L, Gąsior M, Gierlotka M, et al. What has changed in the treatment of ST-segment elevation myocardial infarction in Poland in 2003-2009? Data from the Polish Registry of Acute Coronary Syndromes (PL-ACS). Kardiol Pol. 2011; 69(11): 1109–1118.
- Poloński L, Gasior M, Gierlotka M, et al. Polish Registry of Acute Coronary Syndromes (PL-ACS). Characteristics, treatments and outcomes of patients with acute coronary syndromes in Poland. Kardiol Pol. 2007; 65(8): 861–72; discussion 873.
- GRACE Investigators. Rationale and design of the GRACE (Global Registry of Acute Coronary Events) Project: a multinational registry of patients hospitalized with acute coronary syndromes. Am Heart J. 2001; 141(2): 190–199.
- Alexander KP, Roe MT, Chen AY, et al. CRUSADE Investigators. Evolution in cardiovascular care for elderly patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative. J Am Coll Cardiol. 2005; 46(8): 1479–1487.
- Avezum A, Makdisse M, Spencer F, et al. GRACE Investigators. Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE). Am Heart J. 2005; 149(1): 67–73.
- Alexander KP, Newby LK, Armstrong PW, et al. American Heart Association Council on Clinical Cardiology, Society of Geriatric Cardiology, American Heart Association Council on Clinical Cardiology, Society of Geriatric Cardiology. Acute coronary care in the elderly, part I: Non-ST-segment-elevation acute coronary syndromes: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology. Circulation. 2007; 115(19): 2549–2569.
- Lee PY, Alexander KP, Hammill BG, et al. Representation of elderly persons and women in published randomized trials of acute coronary syndromes. JAMA. 2001; 286(6): 708–713.
- Rogers WJ, Bowlby LJ, Chandra NC, et al. Treatment of myocardial infarction in the United States (1990 to 1993). Observations from the National Registry of Myocardial Infarction. Circulation. 1994; 90(4): 2103–2114.
- Milner KA, Vaccarino V, Arnold AL, et al. Gender and age differences in chief complaints of acute myocardial infarction (Worcester Heart Attack Study). Am J Cardiol. 2004; 93(5): 606–608.
- Polewczyk A, Janion M, Gasior M, et al. Myocardial infarction in the elderly. Clinical and therapeutic differences. Kardiol Pol. 2008; 66(2): 166–72; discussion 173.
- Grupa Robocza Europejskiego Towarzystwa Kardiologicznego (ESC) do spraw rewaskularyzacji mięśnia sercowego oraz Europejskie Stowarzyszenie Chirurgii Serca i Klatki Piersiowej (EACTS). Wytyczne Europejskiego Towarzystwa Kardiologicznego dotyczące rewaskularyzacji mięśnia sercowego. Kardiol Pol. 2010; 68(supl. VIII): 569–638.
- O'Keefe JH, Bailey WL, Rutherford BD, et al. Primary angioplasty for acute myocardial infarction in 1,000 consecutive patients. Results in an unselected population and high-risk subgroups. Am J Cardiol. 1993; 72(19): 107G–115G.
- de Boer SPM, Westerhout CM, Simes RJ, et al. Primary Coronary Angioplasty Versus Thrombolysis-2 (PCAT-2) Trialists Collaborators Group. Mortality and morbidity reduction by primary percutaneous coronary intervention is independent of the patient's age. JACC Cardiovasc Interv. 2010; 3(3): 324–331.
- Polewczyk A, Janion M, Gąsior M, et al. Benefits from revascularisation therapy in the elderly with acute myocardial infarction. Comparative analysis of patients hospitalized in 1992-1996 and in 2005-2006. Kardiol Pol. 2010; 68: 873–881.
- Gasior M, Slonka G, Wilczek K, et al. Comparison of invasive and non-invasive treatment strategies in older patients with acute myocardial infarction complicated by cardiogenic shock (from the Polish Registry of Acute Coronary Syndromes - PL-ACS). Am J Cardiol. 2011; 107(1): 30–36.
- Hochman JS, Sleeper LA, Webb JG, et al. SHOCK Investigators, SHOCK Investigators, SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK Investigators, SHOCK Investigators, SHOCK Investigators. Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock. N Engl J Med. 1999; 341(9): 625–634.
- Grupa Robocza Europejskiego Towarzystwa Kardiologicznego (ESC) do spraw postępowania w ostrym zawale serca z uniesieniem odcinka ST. Wytyczne ESC dotyczące postępowania w ostrym zawale serca z przetrwałym uniesieniem odcinka ST. Kardiol Pol 2012; 70 (): S 255- S. ; 318(supl. VI).
- Brass LM, Lichtman JH, Wang Y, et al. Intracranial hemorrhage associated with thrombolytic therapy for ederly patients with acute myocardial infarction: results from the cooperative cardiovascular project. Stroke. 2000; 31(8): 1802–1811.
- Roffi M, Patrono C, Collet JP, et al. Wytyczne ESC dotyczące postępowania w ostrych zespołach wieńcowych bez przetrwałego uniesienia odcinka ST w 2015 roku. Kardiol Pol. 2015; 73(12): 1207–1294.
- Skolnick AH, Alexander KP, Chen AY, et al. Characteristics, management, and outcomes of 5,557 patients age > or =90 years with acute coronary syndromes: results from the CRUSADE Initiative. J Am Coll Cardiol. 2007; 49(17): 1790–1797.
- Savonitto S, Cavallini C, Petronio AS, et al. Italian Elderly ACS Trial Investigators. Early aggressive versus initially conservative treatment in elderly patients with non-ST-segment elevation acute coronary syndrome: a randomized controlled trial. JACC Cardiovasc Interv. 2012; 5(9): 906–916.
- Gierlotka M, Gąsior M, Tajstra M, et al. Outcomes of invasive treatment in very elderly Polish patients with non-ST-segment-elevation myocardial infarction from 2003-2009 (from the PL-ACS registry). Cardiol J. 2013; 20(1): 34–43.
- Wiviott SD, Braunwald E, McCabe C, et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2007; 357(20): 2001–2015.
- Roe MT, Goodman SG, Ohman EM, et al. Elderly patients with acute coronary syndromes managed without revascularization: insights into the safety of long-term dual antiplatelet therapy with reduced-dose prasugrel versus standard-dose clopidogrel. Circulation. 2013; 128(8): 823–833.
- Wallentin L, Becker RC, Budaj A, et al. PLATO Investigators. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009; 361(11): 1045–1057.
- Husted S, James S, Becker RC, et al. PLATO study group. Ticagrelor versus clopidogrel in elderly patients with acute coronary syndromes: a substudy from the prospective randomized PLATelet inhibition and patient Outcomes (PLATO) trial. Circ Cardiovasc Qual Outcomes. 2012; 5(5): 680–688.
- Ezekowitz J, McAlister FA, Humphries KH, et al. APPROACH Investigators. The association among renal insufficiency, pharmacotherapy, and outcomes in 6,427 patients with heart failure and coronary artery disease. J Am Coll Cardiol. 2004; 44(8): 1587–1592.
- Sahlén A, Varenhorst C, Lagerqvist Bo, et al. Outcomes in patients treated with ticagrelor or clopidogrel after acute myocardial infarction: experiences from SWEDEHEART registry. Eur Heart J. 2016; 37(44): 3335–3342.
- Gierlotka M, Gąsior M, Wilczek K, et al. Temporal trends in the treatment and outcomes of patients with non-ST-segment elevation myocardial infarction in Poland from 2004–2010 (from the Polish Registry of Acute Coronary Syndromes). Am J Cardiol. 2012; 109(6): 779–786.
- James S, Budaj A, Aylward P, et al. Ticagrelor versus clopidogrel in acute coronary syndromes in relation to renal function: results from the Platelet Inhibition and Patient Outcomes (PLATO) trial. Circulation. 2010; 122(11): 1056–1067.
- Magnani G, Storey RF, Steg G, et al. Efficacy and safety of ticagrelor for long-term secondary prevention of atherothrombotic events in relation to renal function: insights from the PEGASUS-TIMI 54 trial. Eur Heart J. 2016; 37(4): 400–408.
- Dai X, Busby-Whitehead J, Alexander KP. Acute coronary syndrome in the older adults. J Geriatr Cardiol. 2016; 13(2): 101–108.
