Key result
An early intervention strategy for NSTEMI or unstable angina reduced death or non-fatal MI at 1 year in men (OR 0.63; 95% CI 0.41-0.98) but not in women (interaction P=0.007).
Why the study?
Does an early intervention strategy reduce death or non-fatal myocardial infarction in patients with unstable angina or non-ST-elevation myocardial infarction, and does this effect differ by gender?
Population
1810 patients (682 women and 1128 men) with non-ST-elevation myocardial infarction or unstable angina
Comparison
Early intervention strategy vs Conservative care
Design
RCT, randomized
Follow-up
1 year
Authors
Loading...
Early invasive strategy benefits men but not women with NSTEMI/unstable angina; challenges uniform guidelines and supports sex-specific trials.
RCT (n=1,810)
Does an early intervention strategy reduce death or non-fatal myocardial infarction in patients with unstable angina or non-ST-elevation myocardial infarction, and does this effect differ by gender?
Effect estimate: OR 0.63 (men), OR 1.79 (women) (95% CI 0.41-0.98 (men), 0.95-3.35 (women))
p-value: p=0.007 (interaction)
An early intervention strategy for NSTEMI or unstable angina significantly reduces death or non-fatal MI at 1 year in men, but this benefit is not observed in women.
Clayton et al. (2004) conducted an RCT in Non-ST-elevation myocardial infarction or unstable angina (n=1,810). Early intervention (angiography followed by revascularization) vs. Conservative care (ischaemia or symptom driven angiography) was evaluated on Death or non-fatal myocardial infarction at 1 year (OR 0.63 (men), OR 1.79 (women), 95% CI 0.41-0.98 (men), 0.95-3.35 (women), p=0.007 (interaction)). An early intervention strategy for NSTEMI or unstable angina reduced death or non-fatal MI at 1 year in men (OR 0.63; 95% CI 0.41-0.98) but not in women (interaction P=0.007).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: