Introduction
If percutaneous coronary intervention (PCI) cannot be performed, it has continued to be an effective treatment option for acute coronary syndromes, especially in patients with ongoing ischemia and large areas of compromised myocardium. This also occurs in cases where PCI is ineffective, insufficient, or fails coronary artery bypass grafting.
Discussion
In people under the age of 80, coronary artery disease (CAD) is a significant source of morbidity and mortality (Thielmann et al., 2021). Nevertheless, clinical trials for cardiovascular diseases have consistently underrepresented older people. Improving outcomes in this high-risk population requires understanding the pathophysiology, epidemiology, and ideal methods of diagnosing and treating CAD in older persons. When caring for older persons with CAD, a patient-centered approach that considers health state, functional capacity and frailty, cognitive skills, and patient preferences is imperative.
The likelihood of having symptoms of CAD rises monotonically with age. According to the National Health and Nutrition Examination Survey, men under 80 had a higher prevalence of coronary heart disease than women (Stone, 2018). The cardiovascular health study and the Framingham heart study both reported similar conclusions. In the atherosclerosis risk in communities study, participants 65 to 84 years of age had a greater incidence of myocardial infarction among black people than white people (Stone, 2018). According to the multi-ethnic study of atherosclerosis, which found that 60% to >90% of older people may have evidence of subclinical coronary atherosclerosis as determined by coronary artery calcium (CAC), carotid intimal-medial thickness, stenosis, and ankle-brachial index, a significantly higher percentage of patients have the subclinical disease (Stone, 2018). Elderly individuals with coronary artery disease frequently had more cardiovascular risk factors complicating their condition, but they were given fewer evidence-based treatments (EBTs).
The prevention of foods with much sugar is part of the patient’s education for coronary artery disease. Most days of the week, one should go for a walk or engage in some other type of physical activity. If one is overweight, one ought to shed weight. Additionally, medications are available to help people with coronary artery disease-related chest pain. A person’s diet should include less salt and saturated fat if they have CAD. Saturated fats and salt both have the potential to raise blood pressure and lower cholesterol, respectively. According to studies, consuming fewer saturated fats can reduce your risk of developing problems like heart attacks. A legal and ethical requirement known as informed consent calls for disclosing information about surgery, including the risks and benefits. Patients should be given sufficient information about their options without being forced to make an informed decision. Additionally, medical specialists must attest that the patient can make decisions at that time. In most elective patients, diagnostic angiography should be done independently of choice to proceed with PCI to improve the informed consent process. Multidisciplinary teams should also be involved.
Conclusion
Even though CAD is crucial for women, there is a persistent misconception that it only affects men. Women have historically been underrepresented in clinical trial enrollment, which has prevented gender-specific data analysis and, as a result, the identification of distinct risk factors exclusive to women. The finding of different incidence rates according to age, with women’s incidence of CAD being lower than men’s but rising progressively after the fifth decade, supports this idea (Saeed et al., 2017, p. 191). The distribution of CAD risk factors differs between men and women throughout age ranges. This disparity may have been overlooked, leading some people to believe that women have a lesser risk of developing CAD than males. In addition, compared to men, women are more prone to experience symptoms that are deemed abnormal (Pathak et al., 2017, p. 533). To speed up diagnosis and treatment, launch aggressive risk factor interventions, and enhance the quality of life, it is vital to understand better how cardiac symptoms occur in female patients.
References
Pathak, L. A., Shirodkar, S., Ruparelia, R., & Rajebahadur, J. (2017). Coronary artery disease in women. Indian Heart Journal, 69(4), 532-538. Web.
Saeed, A., Kampangkaew, J., & Nambi, V. (2017). Prevention of cardiovascular disease in women. Methodist DeBakey Cardiovascular Journal, 13(4), 185-192. Web.
Stone, G. W. (2018). Coronary artery disease in patients ≥80 years of age. Journal of the American College of Cardiology, 71(18), 2015-2040. Web.
Thielmann, M., Wendt, D., Slottosch, I., Welp, H., Schiller, W., Tsagakis, K., Schmack, B., Weymann, A., Martens, S., Neuhäuser, M., Wahlers, T., Choi, H., Ruhparwar, A., & Liakopoulos, J. (2021). Coronary artery bypass graft surgery in patients with acute coronary syndromes after primary percutaneous coronary intervention: a current report from the north‐rhine Westphalia surgical myocardial infarction registry. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 10(18). Web.