作者
Stefano Cacciatore, Luigi Spadafora, Marco Bernardi, Mattia Galli, Matteo Betti, Francesco Perone, Giulia Nicolaio, Emanuele Marzetti, Anna Maria Martone, Francesco Landi, Elad Asher, Maciej Banach, Olivier Hanon, Giuseppe Biondi-Zoccai, Pierre Sabouret
发表日期
2023/8/11
来源
Journal of clinical medicine
卷号
12
期号
16
页码范围
5233
出版商
MDPI
简介
Coronary artery disease (CAD) is highly prevalent in older adults, yet its management remains challenging. Treatment choices are made complex by the frailty burden of older patients, a high prevalence of comorbidities and body composition abnormalities (e.g., sarcopenia), the complexity of coronary anatomy, and the frequent presence of multivessel disease, as well as the coexistence of major ischemic and bleeding risk factors. Recent randomized clinical trials and epidemiological studies have provided new data on optimal management of complex patients with CAD. However, frail older adults are still underrepresented in the literature. This narrative review aims to highlight the importance of assessing frailty as an aid to guide therapeutic decision-making and tailor CAD management to the specific needs of older adults, taking into account age-related pharmacokinetic and pharmacodynamic changes, polypharmacy, and potential drug interactions. We also discuss gaps in the evidence and offer perspectives on how best in the future to optimize the global strategy of CAD management in older adults.
学术搜索中的文章
S Cacciatore, L Spadafora, M Bernardi, M Galli, M Betti… - Journal of clinical medicine, 2023