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老年人非ST段抬高急性冠脉综合征和ST段抬高性心肌梗死的共同问题包括症状不典型、合并危险因素多、临床证据不充分。老年人非ST段抬高急性冠脉综合征早期给予经皮冠状动脉介入治疗减少死亡或心肌梗死绝对和相对危险度,长期随访显示其改善生存和症状的优越性。老年人ST段抬高性心肌梗死介入治疗主要获益来自减少再次心肌梗死和重复血运重建;再灌注及时性和可行性是挽救濒危心肌和改善临床预后的重要因素;选择经皮冠状动脉介入治疗或溶栓取决于患者是否存在心源性休克、时间延搁、合并病等因素,多数情况下倾向选择经皮冠状动脉介入治疗。年龄是老年人急性冠脉综合征介入治疗临床疗效的重要影响因素。
Common problems in elderly patients with non-ST segment elevation acute coronary syndrome and ST-segment elevation myocardial infarction include atypical symptoms, multiple combined risk factors, and inadequate clinical evidence. Elderly patients with non-ST segment elevation acute coronary syndrome treated by percutaneous coronary intervention to reduce the absolute or relative risk of death or myocardial infarction, long-term follow-up showed its superiority in improving survival and symptoms. The main benefit of interventional treatment of ST-segment elevation myocardial infarction in the elderly is the reduction of recurrent myocardial infarction and repeated revascularization. The timely and feasible reperfusion is an important factor to save the endangered myocardium and improve the clinical prognosis. Choosing percutaneous coronary intervention Treatment or thrombolysis depends on whether the patient has cardiogenic shock, time delay, co-morbidities and other factors, in most cases the preferred choice of percutaneous coronary intervention. Age is an important influencing factor in the clinical efficacy of interventional therapy for the elderly with acute coronary syndrome.