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Ischaemic heart disease 

Ischaemic heart disease
Ischaemic heart disease

Martina Rafanelli

, Francesco Orso

, and Niccolò Marchionni

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date: 27 January 2022

Advancing age is associated with changes in vascular and cardiac properties that increase the likelihood of atherosclerosis, which is the basic pathophysiological mechanism in most of the clinical presentations of ischaemic heart disease (IHD). Recovery, once the tissue’s damage has occurred, is more difficult because of age-related changes in damage responsiveness. Clinical management of IHD in older people is complicated by atypical presentation that often makes the diagnosis challenging and causes treatment delay. The management of acute coronary syndromes (ACS) and stable coronary artery disease in this population should be driven by current clinical guidelines, even though older people are poorly represented in clinical trials. The choice of pharmacological therapy needs a careful balance between risks and benefits. Given the increase in morbidity and mortality in older patients with ACS, aggressive risk factor modification is vital for decreasing recurrent events.

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