The Living Guidelines: UA/NSTEMI Recommendations for UA/NSTEMI in Elderly Polling Results for CLASS I Guidelines

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Class I Guidelines
1. Older patients with UA/NSTEMI should be evaluated for appropriate acute and long term therapeutic interventions in a similar manner as younger patients with UA/NSTEMI. (Level of Evidence: A)

 UA/NSTEMI Guidelines Class I Recommendation 1 for UA/NSTEMI in Post UA/NSTEMI in Elderly should be: CLASS I CLASS IIa CLASS IIb CLASS III

2. Decisions on management of older patients with UA/NSTEMI should not be based solely on chronologic age but should be patient centered, with consideration given to general health, functional and cognitive status, comorbidities, life expectancy, and patient preferences and goals. (Level of Evidence: B)

 UA/NSTEMI Guidelines Class I Recommendation 2 for UA/NSTEMI in Post UA/NSTEMI in Elderly should be: CLASS I CLASS IIa CLASS IIb CLASS III

3. Attention should be given to appropriate dosing (i.e., adjusted by weight and estimated creatinine clearance) of pharmacological agents in older patients with UA/NSTEMI, because they often have altered pharmacokinetics (due to reduced muscle mass, renal and/or hepatic dysfunction, and reduced volume of distribution) and pharmacodynamics (increased risks of hypotension and bleeding). (Level of Evidence: B)

 UA/NSTEMI Guidelines Class I Recommendation 3 for UA/NSTEMI in Post UA/NSTEMI in Elderly should be: CLASS I CLASS IIa CLASS IIb CLASS III

4. Older UA/NSTEMI patients face increased early procedural risks with revascularization relative to younger patients, yet the overall benefits from invasive strategies are equal to or perhaps greater in older adults and are recommended. (Level of Evidence: B)

 UA/NSTEMI Guidelines Class I Recommendation 4 for UA/NSTEMI in Post UA/NSTEMI in Elderly should be: CLASS I CLASS IIa CLASS IIb CLASS III

5. Consideration should be given to patient and family preferences, quality of life issues, end of life preferences, and socio cultural differences in older patients with UA/NSTEMI. (Level of Evidence: C)

 UA/NSTEMI Guidelines Class I Recommendation 5 for UA/NSTEMI in Post UA/NSTEMI in Elderly should be: CLASS I CLASS IIa CLASS IIb CLASS III