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Discordance between level of risk and intensity of evidence-based treatment in patients with acute coronary syndromes

Ian A Scott
Med J Aust 2007; 187 (8): 479.
Published online: 15 October 2007

In reply: Jelinek rightly draws attention to the need, when caring for patients with acute coronary syndromes, to distinguish disease-related risk from age-related risk arising from frailty, comorbidity, physical disability, cognitive impairment, depression, social isolation, age–treatment interactions, and quality of life. All these factors affect treatment goals in older patients and may, as we conceded, justify withholding certain treatments in individual cases. However, even after accounting for “wise compassion”, under-treatment is still likely because:

  • Ian A Scott

  • Department of Internal Medicine, Princess Alexandra Hospital, Brisbane, QLD.


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