Atherosclerotic Cardiovascular Disease in Older Adults

Purpose of Review Atherosclerotic coronary disease is a major cause of morbidity and mortality in older adults. The purposes of this review are to summarize our current knowledge about best practices in the management of coronary artery disease in this population and to highlight remaining gaps in our understanding. Recent Findings Elderly patients are far less likely than their younger counterparts to receive guideline-based care after presenting with an acute coronary syndrome (ACS). However, despite some attenuation of benefit with increasing age, recent studies have shown improved outcomes with an early invasive strategy, even amongst patients over 90 years of age. Summary The best currently available evidence suggests numerous scenarios in which elderly patients may benefit from coronary revascularization in addition to medical therapy. In particular, patients with refractory angina and those who present with ACS can expect improvements in quality of life and mortality, respectively, with guideline-directed therapy.