Faculty Opinions recommendation of 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.

Abstract

Current data support the use of reperfusion therapies, including fibrinolysis, for the treatment of ST-elevation myocardial infarction up to an age of 85 years {1}. As this report from American College of Cardiology Foundation/American Heart Association Task Force underlines, the selection between fibrinolytics or percutaneous coronary intervention (PCI) is largely determined by factors other than age, such as time from presentation, travel time to cardiac catheterization laboratory, comorbidity, and signs of cardiogenic shock. It should be noted that the safety and efficacy of reperfusion, specifically fibrinolytic therapy, in the very elderly (≥85 years of age) has yet to be determined, as the risks of intracranial bleeding and cardiac rupture increase with age. This Recommendation is of an article referenced in an F1000 Faculty Review also written by Niels Engberding and Nanette K. Wenger.