Acute Coronary Syndrome (ACS)

Acute coronary syndromes (ACS) refer to a group of life-threatening conditions caused by reduced blood flow to the heart, typically due to plaque rupture and blood clot formation in the coronary arteries. ACS includes unstable angina, non-ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI).

Symptoms include chest pain, shortness of breath, nausea, and sweating. Immediate diagnosis and treatment are critical to prevent heart damage. Management involves medications (antiplatelets, anticoagulants, beta-blockers, statins), lifestyle changes, and procedures like angioplasty or coronary artery bypass grafting (CABG). Early intervention significantly improves survival and long-term heart health.

Revascularization in Frail Patients With Acute Coronary Syndrome (ACS)

Recent studies highlight the importance of tailoring treatment strategies for frail patients presenting with ACS. Revascularization, involving percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), has shown both short- and long-term cardiovascular (CV) benefits in this population.

A large-scale retrospective study using the UK’s Hospital Episode Statistics database examined over 565,000 ACS patients, categorizing them by frailty risk (low, intermediate, and high). Findings revealed that frail patients, often underrepresented in clinical trials, experienced significant reductions in CV mortality following revascularization, particularly in the first year after ACS. Notably, high and intermediate frailty patients saw greater immediate mortality benefits compared to low-frailty patients. However, the benefits diminished over a five-year follow-up, especially for those with high frailty​

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