Attach importance to the diagnosis and treatment of coronary heart disease in the oldest-old
-
摘要: 中国已进入了老龄化社会,而人口老龄化的特点是高龄老人(≥ 80或 ≥ 85岁)数量增长迅速,高龄老人冠心病发病率也逐年增加。高龄老人冠心病因其临床特点有别于一般成人冠心病,易导致漏诊和误诊。我们应该关注和重视高龄老人这一特殊群体,基于循证医学依据,遵循临床指南,坚持个体化原则,积极控制多种冠心病的危险因素,针对高龄老人冠心病的临床症状和并发症特点,及时调整治疗方案,进一步延长患者寿命、减少冠心病心血管事件发生。Abstract: China has become an aging society with a rapid growth of the oldest-old(aged over 80 or 85),which is a modern characteristic of population aging.The incidence of coronary heart disease(CHD)in the oldestold has increased year by year.As its clinical features differ from average adults,CHD in the oldest-old is prone to be misdiagnosed and missed diagnosed.Thus,more concern and attention should be given to this specific group in accordance with evidence-based medicine,clinical guidelines,individualized therapy,as well as risk factor control.Moreover,treatment program should be adjusted timely according to the clinical features of symptoms and complications of CHD in the oldest-old,so as to increase life span and decrease incidence of cardiovascular events in these patients.
-
Key words:
- coronary heart disease /
- population aging /
- the oldest-old
-
[1] LONGO D L.Harrison's principles of internal medi-cine[M].18ed.New York:McGraw-Hill,2011:10-12.
[2] RODONDI N,LOCATELLI I,AUJESKY D,et al.Framingham risk score and alternatives for prediction of coronary heart disease in older adults[J].PloS One,2012,7:e34-87.
[3] POLONSKY T S,MCCLELLAND R L,JORGENS-EN N W,et al.Coronary artery calcium score and risk classification for coronary heart disease prediction[J].JAMA,2010,303:1610-1616.
[4] WILLIAMS M A,FLEG J L,ADES P A,et al.Sec-ondary prevention of coronary heart disease in the eld-erly(with emphasis on patients ≥ 75years of age)[J].Circulation,2002,105:1735-1743.
[5] 王朝晖.关注特殊人群急性冠状动脉综合征[J].临床心血管病杂志,2006,22(11):641-642.
[6] WENGER N K,SHAW L J,VACCARINO V.Cor-onary heart disease in women:Update2008[J].Clin Pharmacol Ther,2008,83:37-51.
[7] PFISTERER M,BUSER P,OSSWALD S,et al.Out-come of elderly patients with chronic symptomatic coro-nary artery disease with an invasive vs optimized medical treatment strategy[J].JAMA,2003,289:1117-1123.
[8] American Geriatrics Society Beers Criteria Update Ex-pert P.American geriatrics society updated beers cri-teria for potentially inappropriate medication use in ol-der adults[J].J Am Geriatr Soc,2012,60:616-631.
[9] ALLEN MAYCOCK C A,MUHLESTEIN J B,HORNE B D,et al.Statin therapy is associated with reduced mor-tality across all age groups of individuals with significant coronary disease,including very elderly patients[J].JACC,2002,40:1777-1785.
[10] KVAN E,PETTERSEN K I,LANDMARK K,et al.Treatment with statins after acute myocardial in-farction in patients ≥ 80years:Underuse despite gen-eral acceptance of drug therapy for secondary preven-tion[J].Pharm Drug Saf,2006,15:261-267.
[11] WEINTRAUB W S,SPERTUS J A,KOLM P,et al.Effect of pci on quality of life in patients with sta-ble coronary disease[J].New Eng J Med,2008,359:677-687.
[12] ANDERSON J L,ADAMS C D,ANTMAN E M,et al.ACC/AHA2007guidelines for the management of patients with unstable angina/non-ST-elevation myo-cardial infarction:A report of the American College of Cardiology/American Heart Association task force on practice guidelines(writing committee to revise the2002guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction)developed in collaboration with the American college of emergency physicians,the society for cardiovascular angiography and interventions,and the society of thoracic surgeons endorsed by the American association of cardiovascular and pulmonary rehabilitation and the society for academic emergency medicine[J].JACC,2007,50:e1-157.
[13] KUSHNER F G,HAND M,SMITH Jr S C,et al.2009focused updates:ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction(updating the 2004guideline and 2007focused update)and ACC/AHA/SCAI guidelines on percutaneous coronary intervention(updating the 2005guideline and 2007focused update):A report of the American College of Cardiology foundation/American Heart Association task force on practice guidelines[J].JACC,2009,54:2205-2241.
[14] SHAH P,NAJAFI A H,PANZA J A,et al.Outcomes and quality of life in patients ≥ 85years of age with ST-elevation myocardial infarction[J].Am J Cardiol,2009,103:170-174.
[15] MEDINA H M,CANNON C P,ZHAO X,et al.Quality of acute myocardial infarction care and outcomes in 33,997patients aged 80years or older:Findings from get with the guidelines-coronary artery disease[J].Am Heart J,2011,162:283-290.
计量
- 文章访问数: 35
- PDF下载数: 15
- 施引文献: 0