Management of MI depending on age

Dr P.J. Devereaux is a professor in the Department of Health Research Methods, Evidence, and Impact and Department of Medicine and director of the Division of Cardiology at McMaster University.

Should the management of myocardial infarction (MI) vary depending on the patient’s age?

P.J. Devereaux, MD, PhD: Age is an important factor in terms of considering both the prognosis of dying from MI but also potential reactions to medications.

You want to take into consideration the potential bleeding risk. As we get older, there may be a higher risk of bleeding. If patients have significant bleeding issues, that is going to be relevant to choices around antiplatelets and anticoagulants.

But in general most treatment is going to be the same unless, once again, there are extenuating comorbid conditions specifically related to bleeding with an older population that would make you more cautious about some of the therapies we would use in most patients with an acute MI.

See also

Treatment of hypertension in the elderly What is the current approach to the treatment of hypertension in elderly patients?
Revascularization in older patients with chronic limb ischemia Should revascularization procedures in chronic limb ischemia be limited in older patients depending on their age or performance status?
Roles of CK and CK-MB in suspected myocardial infarction Is there still a role for creatine kinase (CK) or creatine kinase–myocardial band (CK-MB) in a patient with suspected myocardial infarction (MI)?
New definition of myocardial infarction and its practical implications A lecture by Dr P.J. Devereaux, from McMaster University, Canada, delivered at McMaster International Review Course in Internal Medicine (MIRCIM) in May 2019.
Duration of dual antiplatelet therapy after PCI What should be the duration of dual antiplatelet therapy in patients after percutaneous coronary interventions (PCIs)?
What is new in the management of acute coronary syndromes A lecture by Dr Zaza Iakobishvilil, from Rabin Medical Center, Israel, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2018.
How to keep patients with chronic heart failure out of hospital A lecture by Dr Harriette Van Spall, from McMaster University, Canada, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2018.

Management of MI depending on age

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