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Explaining inequalities in receipt of care in the older patient with acute coronary syndrome

Mamas

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Authors



Abstract

The world's population is ageing and patients with acute coronary syndromes (ACS) are presenting later in life such that a third or more are now aged =70.1 ACS mortality rates are higher in older patients,1 and absolute benefits of treatment are, therefore, potentially greater if the balance against harms remains favourable. Randomized trials of both invasive and pharmaceutical ACS treatments have confirmed that efficacy extends to the oldest patients,2,3 yet observational studies continue to show that they are less likely than their younger counterparts to receive these evidence-based therapies.4 Potential reasons for this include the supervision of their care by non-specialists, multiple co-morbidities that limit treatment options and increased complications from treatment that occur more commonly in older patients. Whether the risk-treatment paradox that characterizes the care of older patients with ACS is truly paradoxical or whether it is a reflection of appropriate management decisions is an important question that has not hitherto been answered.

Citation

Mamas. (2016). Explaining inequalities in receipt of care in the older patient with acute coronary syndrome. European Heart Journal - Quality of Care and Clinical Outcomes, 59-61. https://doi.org/10.1093/ehjqcco/qcw011

Acceptance Date Feb 1, 2016
Publication Date Mar 16, 2016
Journal European Heart Journal - Quality of Care and Clinical Outcomes
Print ISSN 2058-5225
Publisher Oxford University Press
Pages 59-61
DOI https://doi.org/10.1093/ehjqcco/qcw011
Publisher URL http://dx.doi.org/10.1093/ehjqcco/qcw011