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Acute coronary syndrome

The AHA Releases a Statement on the Management of Acute Coronary Syndrome in Older Adults

Jessica Ganga
01/12/2023

The American Heart Association (AHA) recently released a 31-page statement that addresses the management of acute coronary syndrome (ACS) in older adults.1 The recent AHA statement was the first update since 2007 on treating ACS in older adults.2

According to the researchers, “diagnostic and therapeutic advances during the past decades have substantially improved health outcomes for patients with [ACS].” But the researchers explain further that the outcomes for ACS in the older adult population are relatively worse when compared to the younger adult population.

The researchers explain that geriatric syndromes (frailty, multimorbidity, impaired cognitive and physical function, polypharmacy) can undermine the capacity for beneficial change in patients after guideline-based treatments. Further, the presence of geriatric syndromes may affect the resiliency of older adults to recover and survive from the disease.

In the AHA scientific statement, the researchers:

  1. Review psychological changes related to age that predispose to ACS and management complexity
  2. Describe how commonly encountered geriatric syndrome impact cardiovascular disease outcomes
  3. Recommend management strategies that are age appropriate and consistent with guidelines for revascularization and acute coronary syndrome

For the management of revascularization and ACS, the researchers recommend several strategies including the transition of care for patients, and the use of cardiac rehabilitation.


References:

  1. Damluji AA, Forman DE, Wang TY, et al. Management of acute coronary syndrome in the older adult population: a scientific statement from the American Heart Association. Circulation. Published online December 12, 2022. doi:10.1161/CIR. 0000000000001112
  2. Alexander KP, Newby LK, Cannon CP, et al. Non-ST-segment-elevation acute coronary syndromes: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology. Circulation. 2007;115:2549-2569. doi:10.1161/CIRCULATIONAHA.107.182615