I hope that the study will be continued for several more years.
Elderly May Benefit from Invasive Treatment for NSTEMI or Unstable Angina — Physician’s First Watch
Elderly May Benefit from Invasive Treatment for NSTEMI or Unstable Angina
By Kelly Young
An invasive strategy following non-ST-elevation myocardial infarction (NSTEMI) or unstable angina may benefit octogenarians more than medical therapy alone, according to a Lancet study.
Researchers in Norway randomized roughly 450 patients aged 80 and older with unstable angina or NSTEMI to either an invasive or conservative strategy. The invasive approach involved early coronary angiography and immediate assessment for percutaneous coronary intervention, coronary artery bypass graft, or optimal medical treatment. The conservative strategy used optimal medical therapy alone.
During a median follow-up of 1.5 years, the primary outcome — a composite of myocardial infarction, stroke, death, and any condition requiring urgent revascularization — occurred significantly less often with the invasive strategy than with the conservative approach (41% vs. 61%). Complication rates were similar in the groups.
The benefits of the invasive approach decreased with increasing age, and the authors were not certain whether those over age 90 would be well served by this strategy. Only 34 patients were above age 90.