Reperfusion treatment in acute myocardial infarction in elderly patients

被引：24

作者：

Van de Werf, Frans ^{[1
]}

机构：

[1] Katholieke Univ Leuven, Dept Cardiovasc Sci, Leuven, Belgium

来源：

KARDIOLOGIA POLSKA | 2018年 / 76卷 / 05期

关键词：

ST-segment elevation myocardial infarction; fibrinolysis; primary percutaneous coronary intervention; elderly; ST-SEGMENT-ELEVATION; THROMBOLYTIC THERAPY; FIBRINOLYTIC THERAPY; PRIMARY ANGIOPLASTY; PRIMARY PCI; OLDER; CLOPIDOGREL; ALTEPLASE; EFFICACY; STRATEGY;

D O I：

10.5603/KP.a2018.0092

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

In this paper the 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", particularly in older STEMI patients, are highlighted. It will become clear at the end of this review that the 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 the current knowledge have been provided.

引用

页码：830 / 837

页数：8

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