REPERFUSION THERAPY IN ELDERLY PATIENTS WITH ACUTE CORONARY SYNDROME

The article presents the peculiarities of interventional intervention in elderly patients with acute coronary syndrome (ACS) basing on the data from the hospital register of the Regional Vascular Center, Republic’s Hospital No. 2 - Center for Emergency Medical Aid for 5 years. The analysis covered 981 patients aged 75 and over. In the period 2015-2019, for this category of patients, coronary angiography was performed in 50% of hospitalized patients, whereas percutaneous coronary intervention (PCI) - only in 1/3 of the patients with ACS. Compared with the general group of patients, less frequent use of coronary angiography and PCI in this category of patients is most often due to late admission to hospital, multivessel coronary artery disease, coronary calcinosis, the presence of a severe multimorbid pathology, refusal to undergo an examination, and the predictable impossibility of taking necessary antithrombotic drugs in the coming months. The study group showed a high hospital mortality rate of 9.9%, especially in the patients with Q-positive MI (31.4%). The analysis of this study will improve patient management and treatment, and improve outcomes for patients of 75 years of age and older.

acute coronary syndrome, coronary heart disease, myocardial infarction, unstable angina, coronary artery, acute heart failure, coronary angiography, reperfusion therapy, endovascular intervention, percutaneous coronary intervention, stenting, thrombolytic therapy, senile age

1. Borja, Ibanez. Рекомендации ESC и РКО по ведению пациентов с острым инфарктом миокарда с подъемом сегмента ST/BorjaIbanez, StefanJames, StefanAgewall, ManuelJ. Antunes; пер. с англ.[2017]. - 64 c.

2. Franz-Josef, Neumann. Рекомендации ESC/EACTS/EAPCI по реваскуляризации миокарда 2018 г. / MiguelSousa-Uva, AndersAhlsson и др. 156 [c]

3. MarcoRoffi, Рекомендации ESC по ведению пациентов с острым коронарным синдромом без стойкого подъема сегмента ST 2015г. / CarloPatrono, Jean-Philippe [Collet и др. 48-60].

4. Андреев А. С. Инвазивные методы лечения при остром коронарном синдроме с подъѐмом сегмента ST / Андреев А. С., Камбаров С. Ю. // Вестн. нац. медико-хирург. центра им. Н. И. Пирогова. - 2018. - № 3. - С. 109-114.

5. Клинические рекомендации: Острый коронарный синдром без подъема сегмента ST на электрокардиограмме. - 2020. - С. 10-17.

6. Клинические рекомендации: Острый коронарный синдром с подъемом сегмента ST на электрокардиограмме. - 2020. - С. 10-14.

7. Острый коронарный синдром в старческом возрасте: статус проблемы и нерешенные вопросы / Ткачева О. Н., Котовская Ю. В., Феоктистова К. В. и др. // Кардиоваскуляр. терапия и профилактика. - 2017. - № 3. - С. 62-67.