Статья
Острый коронарный синдром без подъема сегмента ST у пациентов старческого возраста и долгожителей. Особенности лечения. Обзор литературы и клинический случай
Несмотря на растущую с каждым годом популяцию людей старческого возраста и долгожителей, лечение острого коронарного синдрома в этих группах остается мало освещенной темой, не регламентированной в клинических рекомендациях ввиду отсутствия крупных рандомизированных клинических испытаний.В статье представлен обзор литературы, охватывающий основные вопросы, возникающие в ходе принятия клинических решений при лечении острого коронарного синдрома без подъема сегмента ST у данной группы больных: выбор инвазивной тактики лечения, объема реваскуляризации миокарда, назначение двойной антитромбоцитарной терапии с учетом риска кровотечений, снижения почечной функции и старческой астении.Кроме того, представлен клинический случай успешного лечения 101-летней пациентки с инфарктом миокарда без подъема сегмента ST, которой было проведено чрескожное коронарное вмешательство со стентированием инфаркт-связанной артерии.
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