Problems of providing cardiac care for later-life patients: status and prospects. Part 1. Ischemic heart disease

• Olga N. Tkacheva
• Kotovskaya Yulia V.
• Duplyakov Dmitriy V.

Abstract

With age incidence and prevalence of most cardiovascular diseases increases. Cardiovascular diseases (CVD) are the leading death cause in patients aged 75 years or older. However, despite significant CVD impact on quality of life, incidence of complications and mortality in this age group, data of patients aged 75 years or older are represented in extremely small amount in most cardiology trials. Due to the strict criteria for observation groups formation , almost all randomized clinical trials exclude elderly patients with complex comorbidity, significant decreases in physical or cognitive functions, senile asthenia and those in geriatric homes. As a consequence, modern guidelines cannot provide evidence-based recommendations for very old patients diagnosis and treatment, with whom doctors increasingly face in their daily clinical practice. In 2016, experts from American Heart Association, American College of Cardiology and American Geriatric Society published joint scientific announce which is summarizing missing information in current cardiology guidelines. The article is devoted to conceptual issues of this document and clinical researches directions to obtain data that provide basis for evidence recommendations in managing patients of this complex heterogeneous population suffering from coronary heart disease various forms.

Keywords:elderly age, geriatrics, clinical recommendations, cardiac care, ischemic heart disease

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