SPECIAL ARTICLE  GERIATRIC CARDIOLOGY IN THE ELDERLY 

Minerva Medica 2022 August;113(4):647-66

DOI: 10.23736/S0026-4806.22.08082-X

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Role of new drug therapies and innovative procedures in older patients with heart failure: from trials to clinical practice

Samuele BALDASSERONI ^{1, 2, 3} ✉, Francesco ORSO ^{1, 2}, Andrea HERBST ^{1, 2}, Mario BO ³, Alessandro BOCCANELLI ³, Giovanbattista DESIDERI ³, Renzo ROZZINI ³, Pierfranco TERROSU ³, Paolo ALBONI ³, Niccolò MARCHIONNI ^{2, 3, 4}, Andrea UNGAR ^{1, 2, 3}

¹ Unit of Geriatric Intensive Care Medicine, Careggi University Hospital, University of Florence, Florence, Italy; ² Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy; ³ SICGE - Società Italiana di Cardiologia Geriatrica, Florence, Italy; ⁴ Division of Cardiology, Careggi University Hospital, University of Florence, Florence, Italy

During earliest years, new drug-therapies and novel interventional therapies have been tested to modify the detrimental effect of secondary valve diseases, adverse ventricular remodelling and persistent fluid overload in HF patients. However, the increased prevalence of older or very old patients with HF has made their widespread implementation more problematic due to complex comorbidity, frailty, or overt disability. This growing older population, often excluded by randomized trials, but with elevated risk of hospitalization, required a different clinical and management approach that allows clinicians to take full advantage in reducing mortality and morbidity from these new pharmacological and instrumental therapies. In this perspective, the role of multidisciplinary Heart Team is mandatory for better define a correct decision-making process and tailoring the best pharmacological therapy in each patient and to program a continuum care in a post-acute phase of treatment. In addition, the possibility to plan multicentre registries of several complex cases evaluated by Heart Team could become a very important source of real world data to further refine indications and contraindications of different highly technological therapeutic approach, today based often on randomized clinical trials that do not represent faithfully the current clinical practice population.

KEY WORDS: Heart failure; Aged; Therapeutics