MODERN ASPECTS OF MYOCARDIAL INFARCTION TREATMENT IN OLDER PATIENTS

Abstract

Acute myocardial infarction is one of the most socially important diseases with a high rate of mortality and disability. Cardiovascular heart disease represents the leading cause of death in people those over 65 years. In elderly and old patients atypical forms of myocardial infarction are common. High rate of comorbidities, functional and socioeconomic status, side effects associated with drug administration create difficulty in the diagnosis and selection of treatment in the elderly. These patients need a prolonged monitoring with using an additional examinations and dynamic observation. Compared to younger subjects, elderly patients with acute myocardial infarction are less likely to receive evidence-based treatment, including myocardial revascularization therapy. Endovascular revascularization is currently the main standard for the treatment of acute myocardial infarction, but the advantage of the use of interventional cardiology techniques in elderly patients has been insufficiently studied. Older patients are generally underrepresented in cardiovascular trials. Modern scientific literature, illuminating issues of application of pharmacological and endovascular treatment of acute myocardial infarction in elderly and old age patients, contains fragmented and, in some cases, contradictory data. The authors have taken an attempt to systemize current information in this field based on recommendations, major studies and meta-analyses.