Aging Clinical and Experimental Research

, Volume 6, Issue 4, pp 209–212 | Cite as

The elderly patient with coronary heart disease: Contemporary practices and future challenges

  • Nanette K. Wenger


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Binstock R.H., Post S.G.: Too Old for Health Care? Controversies in Medicine, Law, Economics, and Ethics. Johns Hopkins University Press, Baltimore, MD, 1991.Google Scholar
  2. 2.
    Weaver W.D., Litwin P.E., Martin J.S., Kudenchuk P.J., Maynard C., Eisenberg M.S., Ho M.T., Cobb L.A., Kennedy J.W., Wirkus M.J., the MITI Project Group: Effect of age on use of thrombolytic therapy and mortality in acute myocardial infarction. J. Am. Coll. Cardiol. 18: 657–662, 1991.PubMedCrossRefGoogle Scholar
  3. 3.
    ISIS-2 (Second International Study of Infarct Survival) Collaborative Group: Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. Lancet 2: 349–360, 1988.Google Scholar
  4. 4.
    Wilcox R.G., von der Lippe G., Olsson C.G., Jensen G., Skene A.M., Hampton J.R., for the ASSET Study Group: Trial of tissue plasminogen activator for mortality reduction in acute myocardial infarction. Angio-Scandinavian Study of Early Thrombolysis (ASSET). Lancet 2: 525–530, 1988.Google Scholar
  5. 5.
    AIMS Trial Study Group: Effects of intravenous APSAC on mortality after acute myocardial infarction: Preliminary report of a placebo-controlled clinical trial. Lancet 1: 545–549, 1988.Google Scholar
  6. 6.
    Gruppo Italiano per lo Studio della Streptochinasi nell’lnfarto Miocardico (GISSI): Long-term effects of intravenous thrombolysis in acute myocardial infarction: Final report of the GISSI study. Lancet 2: 871–874, 1987.Google Scholar
  7. 7.
    Wilcox R.G., von der Lippe G., Olsson C.G., Jensen G., Skene A.M., Hampton J.R., for the Anglo-Scandinavian Study of Early Thrombolysis: Effects of alteplase in acute myocardial infarction: 6-month results from the ASSET study. Lancet 335: 1175–1178, 1990.PubMedGoogle Scholar
  8. 8.
    AIMS Trial Study Group: Long-term effects of intravenous anistreplase in acute myocardial infarction: Final report of the AIMS study. Lancet 335: 427–431, 1990.CrossRefGoogle Scholar
  9. 9.
    O’Keefe J.H. Jr., Rutherford B.D., McConahay D.R., Ligon R.W., Johnson W.L. Jr., Giorgi L.V., Crockett J.E., McCallister B.D., Conn R.D., Gura G.M., Good T.H., Steinhaus D.M., Bateman T.M., Shimshak T.M., Hartzler G.O.: Early and late results of coronary angioplasty without antecendent thrombolytic therapy for acute myocardial infarction. Am. J. Cardiol. 64: 1221–1230, 1989.PubMedCrossRefGoogle Scholar
  10. 10.
    Holland K.J., O’Neill W.W., Bates E.R., Pitt B., Topol E.J.: Emergency percutaneous transluminal coronary angioplasty during acute myocardial infarction for patients more than 70 years of age. Am. J. Cardiol. 63: 399–403, 1989.PubMedCrossRefGoogle Scholar
  11. 11.
    Lee T.C., Laramee L.A., Rutherford B.D., McConahay D.R., Johnson W.L. Jr., Giorgi L.V., Ligon R.W., Hartzler CO.: Emergency percutaneous transluminal coronary angioplasty for acute myocardial infarction in patients 70 years of age and older. Am. J. Cardiol. 66: 663–667, 1990.PubMedCrossRefGoogle Scholar
  12. 12.
    Gersh B.J., Kronmal R.A., Frye R.L., Schaff H.V., Ryan T.J., Gosselin A.J., Kaiser G.C., Killip T.III, and Participants in the Coronary Artery Surgery Study: Coronary arteriography and coronary artery bypass surgery: Morbidity and mortality in patients aged 65 years or older. A report from the Coronary Artery Surgery Study. Circulation 76: 483–491, 1983.Google Scholar
  13. 13.
    Smith S.C Jr, Gilpin E., Ahnve S., Dittrich H., Nicod P., Henning H., Ross J. Jr.: Outlook after acute myocardial infarction in the very elderly compared with that in patients aged 65 to 75 years. J. Am. Coll. Cardiol. 16: 784–792, 1990.PubMedCrossRefGoogle Scholar
  14. 14.
    Saunamaki K.I.: Early post-myocardial infarction exercise testing in subjects 70 years or more of age: Functional and prognostic evaluation. Eur. Heart J. 5 (Suppl. E): 93–96, 1984.PubMedCrossRefGoogle Scholar
  15. 15.
    Iskandrian A.S., Heo J., Decoskey D., Askenase A., Segal B.L.: Use of exercise thallium-201 imaging for risk stratification of elderly patients with coronary artery disease. Am. J. Cardiol 61: 269–272, 1988.PubMedCrossRefGoogle Scholar
  16. 16.
    Lam J.Y.T., Chaitman B.R., Glaenzer M.: Safety and diagnostic accuracy of dipyridamole-thallium imaging in the elderly. J. Am. Coll. Cardiol. 11: 585–589, 1988.PubMedCrossRefGoogle Scholar
  17. 17.
    Freeman W.K., Schaff H.V., O’Brien P.C., Orszulak T.A., Naessens J.M., Tajik A.J.: Cardiac surgery in the octogenarian: Perioperative outcome and clinical follow-up. J. Am. Coll. Cardiol. 18: 29–35, 1991.PubMedCrossRefGoogle Scholar
  18. 18.
    Bedotto J.B., Rutherford B.D., McConahay D.R., Johnson W.L., Giorgi L.V., Shimshak T.M., O’Keefe J.H., Ligon R.W., Hartzler G.O.: Results of multivessel percutaneous transluminal coronary angioplasty in persons aged 65 years and older. Am. J. Cardiol. 67: 1051–1055, 1991.PubMedCrossRefGoogle Scholar
  19. 19.
    Jeroudi M.O., Kleiman N.S., Minor S.T., Hess K.R., Lewis J.M., Winters W.L., Raizner A.E.: Percutaneous transluminal coronary angioplasty in octogenarians. Ann. Intern. Med. 113: 423–428, 1990.PubMedCrossRefGoogle Scholar
  20. 20.
    Kelsey S.F., Miller D.P., Holubkov R., Lu A.S., Cowley M.J., Faxon D.P., Detre K.M., and Investigators from the NHLBI PTCA Registry: Results of percutaneous transluminal coronary angioplasty in patients ≽ 65 years of age (from the 1985–1986 National Heart, Lung, and Blood Institute’s Coronary Angioplasty Registry). Am. J. Cardiol. 66: 1033–1038, 1990.PubMedCrossRefGoogle Scholar
  21. 21.
    Thompson R.C., Holmes D.R. Jr., Gersh B.J., Mock M.B., Bailey K.R.: Percutaneous transluminal coronary angioplasty in the elderly. Early and long-term results. J. Am. Coll. Cardiol. 17: 1245–1250, 1991.CrossRefGoogle Scholar
  22. 22.
    Edmunds L.H. Jr., Stephenson L.W., Edie R.N., Ratcliffe M.B.: Open-heart surgery in octogenarians. N. Engl. J. Med. 319: 131–136, 1988.PubMedCrossRefGoogle Scholar
  23. 23.
    Kowalchuk G.J., Siu S.C., Lewis S.M.: Coronary artery disease in the octogenarian: Angiographic spectrum and suitability for revascularization. Am. J. Cardiol. 66: 1319–1323, 1990.PubMedCrossRefGoogle Scholar
  24. 24.
    Mullany C.J., Darling G.E., Pluth J.R., Orszulak T.A., Schaff H.V., Ilstrup D.M., Gersh B.J.: Early and late results after isolated coronary artery bypass surgery in 159 patients aged 80 years and older. Circulation 82 (Suppl. IV): 229–236, 1990.Google Scholar
  25. 25.
    Tsai T.P., Chaux A., Kass R.M., Gray R.J., Matloff J.M.: Aortocoronary bypass surgery in septuagenarians and octogenarians. J. Cardiovasc. Surg. 30: 364–368, 1989.Google Scholar
  26. 26.
    Weintraub W.S., Clements S.D., Ware J., Craver J.M., Cohen C.L., Jones E.L., Guyton R.A.: Coronary artery surgery in octogenarians. Am. J. Cardiol. 68: 1530–1534, 1991.PubMedCrossRefGoogle Scholar
  27. 27.
    Naunheim K.S., Dean P.A., Fiore A.C., McBride L.R., Pennington D.G., Kaiser G.C., Willman V.I., Barner H.B.: Cardiac surgery in the octogenarian. Eur. J. Cardiothorac. Surg. 4: 130–135, 1990.PubMedCrossRefGoogle Scholar
  28. 28.
    Wenger N.K.: Inclusion of Elderly Individuals in Clinical Trials. Cardiovascular Disease and Cardiovascular Therapy as a Model. Marion Merrell Dow, Inc., Kansas City, MO, 1993.Google Scholar
  29. 29.
    Wenger N.K.: Quality of Life: Its Relevance and Applicability to Elderly Patients with Cardiac Illness. In: Martin A., Camm A.J. (Eds.): Geriatric Cardiology. Principles and Practice. John Wiley & Sons, New York, 1994, pp. 721–735.Google Scholar

Copyright information

© Springer Internal Publishing Switzerland 1994

Authors and Affiliations

  • Nanette K. Wenger
    • 1
  1. 1.Department of Medicine, Division of CardiologyEmory University School of Medicine, and Cardiac Clinics, Grady Memorial HospitalAtlantaUSA

Personalised recommendations