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Roberto Bernabei, MD; Giuseppe Zuccalà, MD; Pierugo Carbonin, MD
Catholic University of the Sacred Heart Rome, Italy

JAMA. 1997;278(17):1401.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Both the article by Dr Krumholz and colleagues¹ and the Editorial by Drs Gurwitz and Goldberg² point out that thrombolytic therapy in older patients with myocardial infarction is not yet routinely used in medical practice. Thus, clinical decisions in this setting often are not evidence based; rather, the decision not to administer thrombolytic therapy is mainly driven by physicians' personal opinions, almost never clearly stated. Appropriate choices of treatment for older patients—and even better outcomes—will probably only be achieved when comprehensive geriatric assessment (CGA) becomes part of routine treatment of cardiac disorders. Indeed, patients with heart disease are those who mainly benefit from CGA.² In a recent editorial, Parmley has recommended that cardiologists practice geriatric assessment when dealing with "frail" elderly patients.³

The findings by Krumholz et al highlight the necessity to update evaluation methods in geriatric cardiology. In this study,for example, an older patient's confusion was . . . [Full Text PDF of this Article]

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