Primary angioplasty for acute myocardial infarction in the elderly

Gary E. Lane, David R. Holmes

Research output: Contribution to journalReview article

11 Scopus citations

Abstract

Elderly patients with acute myocardial infarction present a formidable therapeutic challenge. Although there appears to be a survival benefit from thrombolytic therapy for the eligible elderly patient, persistent concerns regarding the risk of intracranial hemorrhage impedes utilization in this age group. Primary or direct angioplasty of the infarct artery has been proven to be an effective modality for reperfusion. Randomized comparisons suggest an advantage over thrombolysis in terms of achieving superior patency and mitigating recurrent ischemic events. Primary angioplasty expands the reperfusion population by including many patients ineligible for thrombolysis and is more effective for treating patients at high risk, such as those with cardiogenic shock. Acute angiography accumulates important prognostic and decision-facilitating information. The benefits of primary angioplasty are more impressive for the aging patient. The survival gain and reduction in intracranial hemorrhage may combine to magnify the advantages of performing angioplasty on patients in this group. Emerging evidence concerning the aging population validates continued examination of this invasive reperfusion approach. (C) 2000 Lippincott Williams and Wilkins.

Original languageEnglish (US)
Pages (from-to)305-313
Number of pages9
JournalCoronary Artery Disease
Volume11
Issue number4
DOIs
StatePublished - Jul 8 2000

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Keywords

  • Angioplasty
  • Coronary artery disease
  • Elderly
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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