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September 30, 2018Catheterization and Cardiovascular Interventions

Impact of an invasive strategy in the elderly hospitalized with acute coronary syndrome with emphasis on the nonagenarians

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Key result

An invasive strategy for nonagenarians with acute coronary syndrome was associated with reduced in-hospital all-cause mortality compared to a conservative strategy (12.0% vs 25.1%; P=0.001).

Why the study?

Does an invasive strategy reduce in-hospital all-cause mortality in elderly patients hospitalized with acute coronary syndrome?

Population

4,569 consecutive patients hospitalized with acute coronary syndrome at 24 Canadian hospitals, including…

Comparison

Invasive strategy vs Conservative strategy

Design

Cohort

Follow-up

in-hospital

Authors

ÉCÉtienne CouturePFPaul FarandMNMichel Nguyen

Discussion

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Member takes

Overview

May support invasive strategy in nonagenarians with ACS despite higher bleeding; leaves open confirmation by randomized trials.

Study Design

Type

Observational (n=4,569)

Multicenter

Yes

Structured PICO

Does an invasive strategy reduce in-hospital all-cause mortality in elderly patients hospitalized with acute coronary syndrome?

P
Population
4,569 consecutive patients hospitalized with acute coronary syndrome (ACS) at 24 Canadian hospitals, including 2,395 <70 years old, 1,031 septuagenarians, 941 octogenarians, and 202 nonagenarians.
I
Intervention
Invasive strategy
C
Comparator
Conservative strategy
O
Outcome
In-hospital all-cause mortalityhard clinical

Main Result

Absolute Event Rate: 12% vs 25.1%

p-value: p=0.001

An invasive strategy in elderly patients, including nonagenarians, presenting with ACS is associated with lower in-hospital mortality but higher bleeding risk.

Cite This Study

Couture et al. (2018) conducted an observational in Acute coronary syndrome (n=4,569). Invasive strategy vs. Conservative strategy was evaluated on In-hospital all-cause mortality in nonagenarians (p=0.001). An invasive strategy for nonagenarians with acute coronary syndrome was associated with reduced in-hospital all-cause mortality compared to a conservative strategy (12.0% vs 25.1%; P=0.001).

synapsesocial.com/papers/6a1d4cc71c2cbcb15c5e176ehttps://doi.org/10.1002/ccd.27877
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The impact of aging on acute coronary syndromes: an EHR-based analysis2025
  2. 2Effect of invasive strategy on long-term mortality in elderly patients presenting with acute coronary syndrome2020 · 6 citations
  3. 3Early Invasive or Conservative Strategies for Older Patients With Acute Coronary Syndromes2025 · 6 citations
  4. 4Invasive Strategy in Octogenarians with Non-ST-Segment Elevation Acute Myocardial Infarction2024 · 1 citations
  5. 5Effect of an invasive strategy on in-hospital outcome in elderly patients with non-ST-elevation myocardial infarction2007 · 149 citations