Many shades of grey: Seeking the optimal medical therapy of acute coronary syndrome in older people

Elizabeth D. Paratz, Steven Nicolaides, Jamie Layland

Research output: Contribution to journalReview ArticleResearchpeer-review


Ischaemic heart disease is the leading cause of death worldwide. Age is the strongest risk factor, yet older patients are consistently underrepresented in clinical trials. With an ageing population, knowledge of the evidence base for the treatment of older patients with acute coronary syndrome (ACS) is crucial. As people age, their responses to medications change, and they may become more susceptible to adverse effects of cardiovascular medications. Management of ACS in older people may be further complicated by the presence of comorbidities, polypharmacy and frailty. Treatment decisions need to be individualised, with consideration of patient preferences, functional and cognitive status and life expectancy. This review aims to summarise the current data for the management of older patients with ACS, with a focus on pharmacological treatment.

Original languageEnglish
Pages (from-to)403-410
Number of pages8
JournalJournal of Pharmacy Practice and Research
Issue number5
Publication statusPublished - Oct 2017


  • Acute coronary syndrome
  • Drug therapy
  • Geriatrics
  • Myocardial ischaemia

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