Coronary artery disease (CAD) is one of the leading causes of death in both
men and women aged > 65 years. However, older patients have been underrepresented
in clinical trials resulting in limited data about the effectiveness of different treatment
strategies in this population. Furthermore, the atypical clinical presentations of CAD in
elderly patients, often make diagnosis challenging and can lead to suboptimal
implementation of treatment and secondary preventive measures by health care
professionals. This chapter reviews clinical presentations and diagnosis consideration
of CAD in the elderly. This review will also address clinical challenges that often arise
when considering medication therapy and percutaneous coronary intervention (PCI) in
the elderly, as well as cardiac rehabilitation in this population. To optimize the benefits
of therapy in the elderly, providers should consider complex interplay of variables such
as comorbidities, functional and socioeconomic status, side effects associated with
multiple drug administration, and individual biological variability.
Keywords: Acute coronary syndrome, Angina, Bleeding risk, Coronary artery
disease, Medication therapy, Older adults, Percutaneous coronary intervention,
Polypharmacy, Revascularization.
