Key result
Routine invasive strategy cuts MACE ~23% vs conservative care in elderly NSTE-ACS patients.
Why the study?
The optimal management of elderly patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) remains uncertain.
Does a routine invasive strategy reduce major adverse cardiovascular events in elderly patients with non-ST-elevation acute coronary syndrome compared to a conservative strategy?
Population
2,997 elderly patients with NSTE-ACS
Comparison
Routine invasive vs conservative strategies
Design
Systematic review and meta-analysis of randomized controlled trials
Authors
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Supports routine invasive strategy in elderly NSTE-ACS; confirms MACE reduction without excess bleeding.
Systematic Review (n=2,997)
Does a routine invasive strategy reduce major adverse cardiovascular events in elderly patients with non-ST-elevation acute coronary syndrome compared to a conservative strategy?
Effect estimate: HR 0.77 (95% CI 0.65-0.92)
In elderly patients with NSTE-ACS, a routine invasive strategy reduces the risk of MACE, myocardial infarction, and revascularization without a significant increase in bleeding compared to a conservative approach.
Diaz‐Arocutipa et al. (2025) conducted a systematic review in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) (n=2,997). Routine invasive strategy vs. Conservative strategy was evaluated on major adverse cardiovascular events (MACE) (HR 0.77, 95% CI 0.65-0.92). A routine invasive strategy reduced the risk of major adverse cardiovascular events compared to a conservative strategy in elderly patients with NSTE-ACS (HR 0.77; 95% CI 0.65-0.92).
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