Why the study?
Elderly patients with NSTEMI undergo fewer coronary interventions despite guideline recommendations for invasive revascularization assessment.
Does percutaneous coronary intervention reduce all-cause mortality in elderly patients (≥65 years) with NSTEMI compared to a conservative strategy?
Does percutaneous coronary intervention reduce all-cause mortality in elderly patients (≥65 years) with NSTEMI compared to a conservative strategy?
In elderly patients (≥65 years) with NSTEMI, percutaneous coronary intervention is associated with reduced one-year mortality compared to a conservative strategy.
Answers are grounded in this paper and cite their sources.
May support PCI over conservative management in elderly NSTEMI; leaves open need for randomized confirmation.
INTRODUCTION: Although it is recommended that elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) should undergo an assessment for invasive revascularization, these patients undergo fewer coronary interventions despite the current guidelines. The aim of the study is to evaluate the effectiveness of percutaneous coronary intervention on all-cause mortalities monthly and annually in the population. METHODS: Three hundred and twenty-four patients with NSTEMI aged 65 years or older who underwent coronary angiography and treated with conservative strategy or percutaneous coronary intervention were included in the study. All demographic and clinical characteristics of the patients were recorded and one-month and one-year follow-up results were analysed. RESULTS: Two hundred eight cases (64.19%) were treated with percutaneous coronary intervention and 116 cases (35.81%) of the participant were treated with conservative methods. The mean age of the participants was 75.41 ± 6.65 years. The treatment strategy was an independent predictor for the mortality of one-year (HR: 1.965). Furthermore, Killip class ≥2 (HR:2.392), Left Ventricular Ejection Fraction (HR:2.637) and renal failure (HR: 3.471) were independent predictors for one-year mortality. CONCLUSION: The present study has revealed that percutaneous coronary intervention was effective on one-year mortality in NSTEMI patients over the age of 65. It is considered that percutaneous coronary intervention would decrease mortality in these patients but it should be addressed in larger population studies.
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Gündoğmuş et al. (2020) studied this question.
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