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Journals / Türk Kardiyoloji Derneği Arşivi / 2017 / Cilt: 45 - Sayı: Suppl. 5

Interventional therapy indications in the elderly - are they different?

Yaşlılarda girişimsel tedavi endikasyonları - fark var mı?

Sema GÜNERİ
Pages
39–41
Publication Date
2022-11-06
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

We need randomized trials including mainly older patients in this era.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:The prevalance of cardiovascular disease increases with age and cardiovascular disease is the leading cause of death in adults >75 years of age.
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Key Findings & Data:But complex co-morbidities, significant physical or cognitive disabilities can change our decision.
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Conclusion & Impact:We need randomized trials including mainly older patients in this era.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

The prevalance of cardiovascular disease increases with age and cardiovascular disease is the leading cause of death in adults >75 years of age. However many trials have excluded older patients. So we don’t have randomized trials but only limited subgroup analysis or registries for older patients. In general the indications for intervention and revascularization are not different in elderly patients. But complex co-morbidities, significant physical or cognitive disabilities can change our decision. Complex Coronary anatomy and the complications of the procedure is high in older patients. Long term mortality is similar in patients treated with Coronary artery bypass graft surgery or percutaneous coronary intervention, but re-intervention is higher in coronary intervention group. Invazive approach is superior to conservative treatment even in very elderly patients with acute coronary syndrome. We need randomized trials including mainly older patients in this era.

Özet

Yaşla birlikte kardiyovasküler hastalık riski artmaktadır. Yetmiş beş yaş üstü kişilerde kardiyovasküler hastalık bir numaralı ölüm nedenidir. Halbuki birçok çalışmada yaşlı hastalar çalışmaya alınmamıştır. Bu nedenle randomize çalışmalardan ziyade subgrup analizleri ve kayıt çalışmaları verileri vardır. Genel olarak yaşlılarda girişimsel tedavi ve revaskülarizasyon endikasyonlarının gençlerden farklı olmadığını söyleyebiliriz. Ancak kompleks ko-morbiditeler, ciddi fiziksel veya mental yetersizlik alacağımız kararı değiştirebilir. Yaşlılarda kompleks koroner anatomi ve girişim komplikasyonları yüksektir. Uzun dönem mortalite koroner bypass cerrahisi veya perkütan giri- şimde benzerdir. Ancak perkütan girişim yapılan hastalarda yeniden girişim daha yüksektir. Akut koroner sendromlu çok yaşlı hastalarda bile invaziv tedavi, konservativ tedaviye göre daha üstündür. Girişimsel tedavi konusunda sadece yaşlı hastaları alan daha fazla randomize çalışmaya ihtiyaç vardır.

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Cite This Article

GÜNERİ, S. (2022). Interventional therapy indications in the elderly - are they different?. Türk Kardiyoloji Derneği Arşivi, Cilt: 45 - Sayı: Suppl. 5, 39–41. https://ajindex.com/articles/633355

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