摘要
世界范围内老龄人口不断增加,老年患者在急性冠状动脉综合征(ACS)中所占比例也越来越大。在ACS随机化临床研究中常将老年人,尤其是75岁及以上的老年人,排除在外。尽管年龄是影响ACS患者预后的重要因素之一,但在实际临床工作中心血管药物治疗及侵入性的干预措施在老年患者应用比例较低,而这些治疗措施的应用本应能使这些患者受益。其原因包括无充分的试验研究指导临床实践,风险与获益的不确定性,尤其是新的药物及介入治疗。本文阐述了老年ACS的临床特点,根据近年资料总结该类人群的治疗措施。今后的前瞻性研究应包括适当比例的老年ACS患者,以决定其风险与获益。
Given the rapid growth of an aging population worldwide ,an increasing proportion of acute coronary syndromes (ACS) is likely to occur in elderly patients .Traditionally elderly persons ,especially for the persons over 75 years old , have been excluded from clinical randomized trials of ACS .Age is an important determinant of outcomes for patients with ACS ;however ,clinical practice reveals a disproportionately lower use of cardiovascular medications and invasive treatment among elderly patients with ACS who would stand to benefit .Reasons include limited trial data to guide the care of older adults and uncertainty about benefits and risks ,particularly with newer medications or invasive treatments and in the setting of advanced age .We will describe the clinical characteristics in elderly patients with ACS ,focusing on recent data on management of these patients .Going forward ,prospective trials should enroll elderly subjects proportionate to define risk and benefit .
出处
《医学与哲学(B)》
2015年第3期12-14,73,共4页
Medicine & Philosophy(B)
关键词
冠心病
急性冠状动脉综合征
老年人
coronary heart disease
acute coronary syndrome
elderly