Tuesday, July 3, 2007

Researchers need to seek out more elderly patients for cardiac clinical trials
by Kelly Winget, DCRI Communications

Heart disease is the leading cause of death in the United States, and more than 80% of patients who died as a result of heart disease are 65 years or older.

Although there are many new medications and treatments for patients suffering from acute heart problems, a recent study found that elderly patients, even those who would be good candidates, are less likely to receive certain medications or invasive treatments.

DCRI researcher Magnus Ohman, MD, who headed a study published in the May 15, 2007 issue of Circulation, found that there hasn’t been significant randomized clinical research involving elderly patients. As a result, physicians might not have a clear view of the potential risks or benefits involved in treatment. While patients often have their first heart attack around the age of 65, the average person will live for approximately 17 more years. Aggressive treatments after a heart attack can improve the quality of life of many elderly patients.

In order to develop a more accurate sense of how well elderly patients are likely to respond to cardiac medications and invasive treatments, clinical trial teams need to seek out elderly participants. Recruitment restrictions such as age should be removed when possible. During the trial and follow-up periods, researchers should note outcomes such as changes in quality of life or physical functions.

Ohman and the study team noted that researchers need to monitor side effects, such as bleeding rates and kidney failure, because elderly patients are more likely to have adverse reactions than younger patients.

Other DCRI researchers with this study include Karen Alexander, MD, and Kristin Newby, MD. The study reviewed data from the VIGOUR (Virtual Coordinating Centre for Global Collaborative Cardiovascular Research) trials and CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC and AHA Guidelines) registries.