Key result
Invasive management significantly reduced the risk of long-term mortality by 69.1% (HR 0.309) compared to conservative management in elderly patients with NSTEMI.
Why the study?
The optimal management strategy in elderly patients with non-ST-segment elevation myocardial infarction remains debatable.
Does invasive management reduce short- and long-term mortality in elderly patients (aged >75 years) with NSTEMI compared to conservative management?
Observational (n=448)
No
Does invasive management reduce short- and long-term mortality in elderly patients (aged >75 years) with NSTEMI compared to conservative management?
Hazard Ratio: 0.309 (95% CI 0.181–0.529)
Absolute Event Rate: 8.6% vs 23.3%
p-value: p=<0.001
In elderly patients over 75 years with NSTEMI, an invasive management strategy significantly reduces short- and long-term mortality compared to conservative management.
The optimal management strategy in elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) is still debatable. We aimed to investigate the short-and long-term mortality rates of invasive and conservative management in elderly patients with NSTEMI aged over 75 years. METHODS: A total of 448 patients (212 in the invasive group and 236 in the conservative group) were balanced with respect to risk factors using a propensity score matching (PSM) analysis. After PSM analysis, equal sized t wo groups of 376 patients were obtained with no selection bias. Short-and long-term mortality rates were compared between groups. RESULTS: Patients in the conservative group had higher in-hospital (11.2 % vs 4.8 %), short-term (17.5 % to 7.5 %), and long-term mortality rates (23.3 % to 8.6 %) than patients in the invasive group. Kaplan-Meier survival curves showed significant differences of survival probabilities between groups for short-and long-term mortalities. An invasive management reduced the risk of mortality by 69.1 % when compared to conservative management. DISCUSSION AND CONCLUSION: Invasive management had improved benefit on the mortality in elderly patients with NSTEMI aged over 75 years compared to the conservative management.
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Şaylık et al. (2022) conducted an observational in Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) (n=448). Invasive management vs. Conservative management was evaluated on Long-term mortality (HR 0.309, 95% CI 0.181-0.529, p=<0.001). Invasive management significantly reduced the risk of long-term mortality by 69.1% (HR 0.309) compared to conservative management in elderly patients with NSTEMI.
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