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Noninvasive Imaging for the Evaluation of Diastolic Function: Promises Fulfilled Effects of Icosapent Ethyl on Total Ischemic Events: From REDUCE-IT Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main and Multivessel Coronary Artery Disease: Do We Have the Evidence? Usefulness of intravascular ultrasound to predict outcomes in short-length lesions treated with drug-eluting stents Transcatheter Mitral Valve Replacement in Patients with Heart Failure and Secondary Mitral Regurgitation: From COAPT Trial Long-term outcomes following mini-crush versus culotte stenting for the treatment of unprotected left main disease: insights from the Milan and New-Tokyo (MITO) registry Haptoglobin genotype: a determinant of cardiovascular complication risk in type 1 diabetes Subclinical and Device-Detected Atrial Fibrillation: Pondering the Knowledge Gap: A Scientific Statement From the American Heart Association Baseline Characteristics and Risk Profiles of Participants in the ISCHEMIA Randomized Clinical Trial 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

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.