Multiple Chronic Conditions in Older Adults with Acute Coronary Syndromes

Joakim Alfredsson; Karen P Alexander

doi:10.1016/j.cger.2016.01.009

Multiple Chronic Conditions in Older Adults with Acute Coronary Syndromes

Clin Geriatr Med. 2016 May;32(2):291-303. doi: 10.1016/j.cger.2016.01.009. Epub 2016 Feb 18.

Authors

Joakim Alfredsson¹, Karen P Alexander²

Affiliations

¹ Department of Cardiology, Linköping University, Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA.
² Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA. Electronic address: Karen.alexander@duke.edu.

PMID: 27113147
DOI: 10.1016/j.cger.2016.01.009

Abstract

Older adults presenting with acute coronary syndromes (ACSs) often have multiple chronic conditions (MCCs). In addition to traditional cardiovascular (CV) risk factors (ie, hypertension, hyperlipidemia, and diabetes), common CV comorbidities include heart failure, stroke, and atrial fibrillation, whereas prevalent non-CV comorbidities include chronic kidney disease, anemia, depression, and chronic obstructive pulmonary disease. The presence of MCCs affects the presentation (eg, increased frequency of type 2 myocardial infarctions [MIs]), clinical course, and prognosis of ACS in older adults. In general, higher comorbidity burden increases mortality following MI, reduces utilization of ACS treatments, and increases the importance of developing individualized treatment plans.

Keywords: Acute coronary syndrome; Multiple chronic conditions; Myocardial infarction (MI); Older adults; Type 2 MI.

Publication types

Review

MeSH terms

Acute Coronary Syndrome* / epidemiology
Acute Coronary Syndrome* / therapy
Aged
Comorbidity
Humans
Multiple Chronic Conditions / epidemiology
Multiple Chronic Conditions / therapy
Myocardial Infarction* / epidemiology
Myocardial Infarction* / therapy
Prognosis
Risk Adjustment