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Non-ST Elevation Myocardial Infarction in the Elderly. Antithrombotic Therapy and Beyond
Pablo Díez-Villanueva1,*, César Jiménez-Méndez2, José Luis Ferreiro3,4, Pedro Cepas-Guillén5, Clara Bonanad6,7,8, Sergio García-Blas7,9, Albert Ariza-Solé3,4, Juan Sanchís7,8,9, Manuel Martínez-Sellés10,11,12
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1
Cardiology Department, Hospital Universitario La Princesa, 28006 Madrid, Spain
2
Cardiology Department, Hospital Universitario Puerta del Mar, 11009 Cádiz, Spain
3
Department of Cardiology, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, CIBERCV, Spain
4
Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08907 L’Hospitalet de Llobregat, Spain
5
Cardiology Department, Hospital Clinic, 08036 Barcelona, Spain
6
Cardiology Department, Hospital Clínico Universitario, 46010 Valencia, Spain
7
Instituto de Investigación Sanitaria INCLIVA (JR/21/00041), 46010 Valencia, Spain
8
Department of Medicine, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
9
Cardiology Department, Hospital Clínico Universitario, 46010 Valencia, CIBERCV, Spain
10
Cardiology Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, CIBERCV, Spain
11
Universidad Europea de Madrid, 28670 Madrid, Spain
12
Universidad Complutense de Madrid, 28007 Madrid, Spain
*Correspondence: pablo_diez_villanueva@hotmail.com (Pablo Díez-Villanueva)
Rev. Cardiovasc. Med. 2023, 24(7), 201;
https://doi.org/10.31083/j.rcm2407201
Submitted: 1 January 2023 | Revised: 12 March 2023 | Accepted: 22 March 2023 | Published: 13 July 2023
(This article belongs to the Special Issue Advances in Pharmacological Treatments of Acute Coronary Syndromes)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract
Non-ST segment elevation myocardial infarction (NSTEMI) is the most frequent type of acute coronary syndrome in the elderly. Antithrombotic therapy is the cornerstone of pharmacological therapy in the setting of an acute ischemic event, a clinical scenario in which thrombotic and bleeding risks ought to be considered, particularly in older patients. In this article, specific aspects of antithrombotic therapy in elderly patients with NSTEMI are reviewed, including pharmacokinetic and pharmacodynamic characteristics and different clinical situations. The role of frailty and other common geriatric conditions, that are associated with worse prognosis in elderly patients with cardiovascular disease, is also addressed.
Keywords
elderly
acute coronary syndrome
non-ST segment elevation myocardial infarction
antithrombotic therapy
frailty
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