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Coronary revascularisation in older patients with non-ST elevation acute coronary syndromes
  1. Hannah Sinclair1,2,
  2. Vijay Kunadian1,2
  1. 1Faculty of Medical Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
  2. 2Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  1. Correspondence to Dr Vijay Kunadian, Faculty of Medical Sciences, Institute of Cellular Medicine, Newcastle University, 3rd Floor William Leech Building, Newcastle upon Tyne NE2 4HH, UK; vijay.kunadian{at}newcastle.ac.uk

Abstract

With an ageing population, older patients with non-ST elevation acute coronary syndrome are at higher risk of adverse outcomes but are far less likely to receive invasive revascularisation, contemporary antiplatelet therapy or drug-eluting stents than their younger counterparts. Accurate risk stratification in the older age groups may aid individualised decision-making with respect to identifying which patients will benefit most from invasive revascularisation, but more research is needed in this field. Based on current knowledge in this field, it would be appropriate following risk stratification to offer optimal medical therapy plus invasive care to older patients at high risk of future cardiovascular events but at low risk of complications and to offer optimal medical therapy alone to those who are deemed low risk of future events with high risk of developing procedural complications and severely frail patients.

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