scholarly journals Coronary Artery Disease in the Elderly

10.5772/22615 ◽  
2011 ◽  
Author(s):  
Milton Alcaino ◽  
Denisse Lam
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
The Elderly ◽  
Artery Disease

Coronary artery disease in the elderly

1999 ◽  
Vol 9 (1) ◽  
pp. 13-21 ◽  
Author(s):  
SK Glen ◽  
NA Boon
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Treatment Guidelines ◽  
Treatment Options ◽  
The Elderly ◽  
Elderly Subjects ◽  
Younger Patients ◽  
Artery Disease ◽  
Morbid Conditions

Coronary artery disease is extremely common among elderly people and accounts for half of all deaths in those who are more than 65 years old. Although the condition is essentially the same as that encountered in younger patients, the management of coronary artery disease in elderly subjects can be difficult because the anticipated benefits and risks of the various treatment options are often altered by the presence of co-morbid conditions. Moreover, the results of the major outcome studies that underpin most treatment guidelines may not be relevant to the needs of many elderly patients for several reasons.

PTCA in elderly patients: hospital events

1993 ◽  
Vol 2 (2) ◽  
pp. 171-176 ◽  
Author(s):  
MA McGrath ◽  
GI Peet ◽  
JG Franke ◽  
RR Mildenberger ◽  
JE Morch ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Adverse Events ◽  
Coronary Angioplasty ◽  
Tertiary Care ◽  
The Elderly ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Artery Disease ◽  
Transluminal Coronary Angioplasty ◽  
Percutaneous Transluminal

BACKGROUND: Medical treatment of the elderly is changing to include the aggressive management of coronary artery disease with percutaneous transluminal coronary angioplasty. OBJECTIVE: The purpose of this study was to review major hospital events of patients aged 70 years or more, who underwent a first percutaneous transluminal coronary angioplasty. METHODS: A retrospective medical record review was done of 246 consecutive patients of 70 years or more, from January 1985 to December 1988, at a tertiary care community hospital. Adverse events and the factors that influenced outcome were identified. RESULTS: Of 246 patients (age range, 70-85 years, mean = 73.6), 19 died, 4 had a cerebral vascular accident, 11 had a transfusion and 11 underwent coronary artery bypass grafting. Sixteen patients had acute vessel closure and 8 died. Twenty-five patients had one event and 21 patients had more than one. DISCUSSION: The event rate after percutaneous transluminal coronary angioplasty in the elderly is high. CONCLUSIONS: Knowledge of the factors that influence adverse events (diagnostic category, success of procedure, degree of coronary artery disease and age) will assist the critical care team to plan and implement appropriate care.

Cost Effectiveness of Imaging with Nuclear Cardiology

2015 ◽  
Author(s):  
Lawrence M. Phillips ◽  
Leslee J. Shaw
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Nuclear Cardiology ◽  
The Elderly ◽  
Evidence Base ◽  
Negative Evidence ◽  
High Likelihood ◽  
Imaging Data ◽  
Artery Disease

This chapter focuses on the economic data available for cardiovascular (CV) imaging. The total costs of testing are substantively lower than those associated with invasive procedures. There are several ongoing randomized trials, such as the PROMISE trial, that may further add to our evidence base on the cost implications of CV imaging. Data for stress nuclear cardiology supports its utility in terms of a high prognostic accuracy and that this test is economically attractive; notably for patients with a high likelihood of coronary artery disease. Data also supports that this benefit does not only include patients with known coronary artery disease but also the high likelihood subsets of the elderly or functionally impaired where ischemic findings play a fundamental role in ischemia-guided management. Importantly, more recent data support that alternative testing strategies have reduced cost in subsets of patients including lower risk women with stable chest pain and in the acute evaluation of low risk chest pain in the ED. Negative evidence is extremely important for the field of CV imaging and this more recent data should be embraced as defining our limitations in nuclear cardiology.

scholarly journals Noninvasive Testing for Diagnosis of Stable Coronary Artery Disease in the Elderly

2020 ◽  
Vol 21 (17) ◽  
pp. 6263
Author(s):  
Sergey G. Kozlov ◽  
Olga V. Chernova ◽  
Elena V. Gerasimova ◽  
Ekaterina A. Ivanova ◽  
Alexander N. Orekhov
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Elderly Population ◽  
The Elderly ◽  
The United States ◽  
Diagnostic Methods ◽  
Exercise Stress ◽  
Attractive Alternative ◽  
Artery Disease

Efficient diagnostic approaches to detect coronary artery disease (CAD) in elderly patients are necessary to ensure optimal and timely treatment. The population of suspected CAD patients older than 70 years is especially vulnerable and constantly growing. Finding the optimal diagnostic approach is challenging due to certain features of this population, such as high prevalence of comorbidities, existing contraindications to exercise tests or cognitive decline, which hinders correct assessment of the patient’s situation. Moreover, some symptoms of CAD can have variable significance in the elderly compared to younger adult groups. In this review, we present current recommendations of the United States (US) and European cardiologists’ associations and discuss their applicability for diagnostics in the elderly population. Exercise electrocardiogram (ECG) and exercise stress echocardiography (SE) tests are not feasible for a substantial proportion of elderly patients. Coronary computed tomography angiography (CTA) appears to be an attractive alternative for such patients, but is not universally applicable; for instance, it is problematic in patients with significant calcification of the vessels. Moreover, more studies are needed to compare the results delivered by CTA to those of other diagnostic methods. Future efforts should be focused on comparative studies to better understand the limits and advantages of different diagnostic methods and their combinations. It is possible that some of the currently used diagnostic criteria could be improved to better accommodate the needs of the elderly population.

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