PerspectiveVolume 76, Issue 13, September 2020
JOURNAL:J Am Coll Cardiol. Article Link
Cardiovascular Biomarkers and Imaging in Older Adults: JACC Council Perspectives
DE Forman, JA de Lemos, and for the Geriatric Cardiology Section Leadership Council.
Keywords:
aging; biomarkers; cardiovascular testing; imaging; shared decision making; stress testing
ABSTRACT
Whereas the burgeoning population of older adults is intrinsically
vulnerable to cardiovascular disease, the utility of many management
precepts that were validated in younger adults is often unclear. Whereas
biomarker- and imaging-based tests are a major part of cardiovascular
disease care, basic assumptions about their use and efficacy cannot be
simply extrapolated to many older adults. Biology, physiology, and body
composition change with aging, with important influences on
cardiovascular disease testing procedures and their interpretation.
Furthermore, clinical priorities of older adults are more heterogeneous,
potentially undercutting the utility of testing data that are
collected. The American College of Cardiology and the National
Institutes on Aging, in collaboration with the American Geriatrics
Society, convened, at the American College of Cardiology Heart House, a
2-day multidisciplinary workshop, “Diagnostic Testing in Older Adults
with Cardiovascular Disease,” to address these issues. This review
summarizes key concepts, clinical limitations, and important
opportunities for research.