由于我们社会的人口增长和冠状动脉疾病的患病率随着年龄的增长而增加,我们将面临越来越多的心肌ST+高龄患者(>90岁?)的治疗。如果在这个框架内不存在循证医学,有许多登记册可以指导我们的照顾。首先,年龄本身不应成为常规再灌注技术的指标。事实上,建议没有年龄上限。初级血管成形术技术上的成功,这与年轻人口相同,是选择的治疗方法,最好通过桡动脉通路进行。溶栓替代方案,为八十岁老人验证,没有被研究过。出血,神经学,缺血性并发症和医院死亡率比年轻人群更常见,尤其是最初的血液动力学改变很重要,但幸存者有相同的威胁生命,甚至比相同的参考人口年龄更好。考虑到合并症和可能的内脏缺点,这本身甚至证明了对治疗建议的最大粘附力。
Because of the demographic growth of our societies and the increasing prevalence of coronary artery disease with age, we will be increasingly faced with the treatment of myocardial ST+ very elderly patients (>90 years?). If evidence-based medicine does not exist within this framework, there are many registries that can guide us in their care. First, age should not in itself be an indication against reperfusion conventional techniques. In fact recommendations put no upper age limit. The primary angioplasty technical success, which is identical to the younger populations, is the treatment of choice and should be performed preferably by radial arterial access. The thrombolytic alternative, validated for octogenarians, has not been studied for older. Bleeding, neurological, ischemic complications and hospital mortality are more common than in younger populations, especially as the initial hemodynamic alteration is important, but the survivors have the same life-threatening or even better than that of a same reference population ages. Which in itself even justifies maximum adhesion to the therapeutic recommendations taking into account the co-morbidities and possible visceral shortcomings.