Special Issues

Special Issue Title: Acute Coronary Syndromes in the Octogenarians

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· Deadline for manuscript submissions:  30 September 2021


Special Issue Editor

Guest Editor


        Dr. Manuel Martínez-Sellés

        University Hospital Gregorio Mara?ón, Madrid, Spain

Website | E-Mail

Interests: Geriatric cardiology; Heart failure; Acute Coronary Syndromes; Aortic stenosis


Special Issue Information

Dear Colleagues,


Acute Coronary Syndromes (ACS) in Octogenarians are a clinical challenge. The evidence of pharmacological treatments and of invasive approach is less robust than in patients younger than 80 years. Octogenarians have a high incidence of ACS. Moreover, globally, the population aged 80 and over is growing faster than all other age groups. However, octogenarians are seldom included in clinical trails. Moreover, when included, they are usually a highly-selected sample that does not represent elderly patients, with frequent comorbidity and frailty, seen in every-day practice. Octogenarians often sustain a poor outcome after an ACS due to several reasons including atypical presentation and delay in recognition, under treatment and ageism, and the presence of other conditions. Octogenarians commonly do not receive optimal guideline-directed ACS treatment. They have a high baseline risk both of ischemic complications and bleeding events, and also fare worse even with optimal treatment and are more vulnerable to medical errors and drug side-effect. Also, the elderly frequently have more complex and severe coronary disease and a higher rate of treatment complications. Appropriate management of these patients is only possible with a correct comprehensive geriatric assessment elderly that should include the evaluation of frailty, comorbidity, quality of life, cognitive impairment, goals of care, and individual preferences. As the population continues to age, physicians will be confronted with an increasing number of octogenarian with ACS, it is imperative to prepare to assess the overall health status of these patients, and to predict their life expectancy and the tolerance of treatments.


Dr. Manuel Martínez-Sellés

Guest Editor

 

Manuscript Submission Information

Manuscripts should be submitted online at https://rcm.imrpress.org by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Reviews in Cardiovascular Medicine is an international peer-reviewed open access quarterly journal published by IMR Press.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is $1950. Submitted papers should be well formatted and use good English.



Keywords

Acute Coronary Syndrome; Octogenarian; Elderly; Cardiovascular disease


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Planned Papers

Title: Conservative management in the elderly patient with non ST-segment elevation myocardial infarction
Authors: Jorge Martínez Solano


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Long term prognostic benefit of complete revascularization in elderly presenting with NSTEMI: real world evidence
Rosa Agra-Bermejo, Alberto Cordero, Pedro Rigueiro Veloso, Diego Iglesias Álvarez, Belen Álvarez Álvarez, Brais Díaz, Leyre Alvarez Rodríguez, Charigan Abou-Jokh, Belén Cid Álvarez, Jose R. González-Juanatey, Jose M García Acuña
Reviews in Cardiovascular Medicine    2021, 22 (2): 475-482.   DOI: 10.31083/j.rcm2202054
Abstract215)   HTML21)    PDF(pc) (2823KB)(210)       Save
The benefit of complete revascularization in elderly patients with non-ST elevation myocardial infarction (NSTEMI), and multivessel disease remains debated (MVD). The aim of our study was to determine the current long-term prognostic benefit of complete revascularization in this population. A retrospective cohort study of 1722 consecutive elderly NSTEMI patients was performed. Among the study participants 30.4% (n = 524) were completed revascularizated and in 69.6% (n = 1198) culprit vessel only revascularization was performed. A propensity score analysis was performed and we divided the study population into two groups: complete revascularization (n = 500) and culprit vessel only revascularization (n = 500). The median follow-up was 45.7 months, the all cause mortality (44.5% vs 30.5%, p < 0.001) (HR 0.74 (0.57–0.97); p = 0.035) and cardiovascular mortality (32.6% vs 17.4%, p < 0.001) (HR = 0.67 (0.47–0.94); p = 0.021) were significantly lower in patients with complete revascularization. In our study, we observed a long-term benefit of complete revascularization in elderly NSTEMI and MVD patients. Elderly patients should also be managed according to current guidelines to improve their long-term prognosis.
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Non-ST segment elevation myocardial infarction in the elderly
César Jiménez-Méndez, Pablo Díez-Villanueva, Fernando Alfonso
Reviews in Cardiovascular Medicine    2021, 22 (3): 779-786.   DOI: 10.31083/j.rcm2203084
Abstract214)   HTML20)    PDF(pc) (685KB)(224)       Save
Ischemic heart disease constitutes the leading cause of death in Western countries. The general incidence of acute coronary syndromes (ACS), especially non-ST segment elevation myocardial infarction (NSTEMI), is growing. Advanced age is both a strong risk factor for ACS and an independent predictor of poorer clinical outcomes. Management of this entity is often complex in the elderly, while special attention should be focused on comorbidities and geriatric conditions. This article aims to review clinical presentation, identification and management of NSTEMI in the elderly population.
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