Why the study?
It was unclear whether very elderly patients with non-ST-segment elevation myocardial infarction benefit from an invasive strategy versus a conservative strategy.
Does an invasive strategy reduce mortality in patients aged 80 years or older with NSTEMI?
Does an invasive strategy reduce mortality in patients aged 80 years or older with NSTEMI?
In very elderly patients (≥80 years) with NSTEMI, an invasive strategy was associated with significantly lower mortality compared to a conservative strategy.
Invasive strategy was associated with lower mortality in very elderly NSTEMI; leaves open whether randomized trials would confirm benefit.
OBJECTIVE: To investigate whether the very elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) will benefit from an invasive strategy versus a conservative strategy. METHODS: 190 consecutive patients aged 80 years or older with NSTEMI were included in the retrospective study from September 2014 to August 2017, of which 69 patients received conservative strategy and 121 patients received invasive strategy. The primary outcome was death. Multivariate Cox regression models were used to assess the statistical association between strategies and mortality. The survival probability was further analyzed. CONCLUSIONS: An invasive strategy is superior to a conservative strategy in reducing mortality of patients aged 80 years or older with NSTEMI. Our results suggest that an invasive strategy is more suitable for the very elderly patients with NSTEMI in China.
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Sui et al. (2019) studied this question.
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