Key result
Early invasive strategy reduces 30-day MACE in elderly patients with ACS.
Why the study?
Does an early invasive strategy reduce major adverse clinical events in elderly patients with non-ST-elevation acute coronary syndromes?
Does an early invasive strategy reduce major adverse clinical events in elderly patients with non-ST-elevation acute coronary syndromes?
Despite higher risk profiles, elderly patients with NSTE-ACS may derive a greater absolute benefit from an early invasive strategy compared to younger patients, prompting the need for dedicated randomized trials.
Answers are grounded in this paper and cite their sources.
May support early invasive strategy in elderly NSTE-ACS; dedicated RCTs needed before practice change.
The clinical impact of an early invasive strategy (EIS) on elderly patients with acute coronary syndromes (ACSs) has yet to be completely defined because of the poor enrolment of elderly patients in randomized trials in this setting. The reluctance to treat elderly ACS patients is mainly due to the higher risk profile of these patients when percutaneous or surgical revascularization is planned. However, recent clinical data from different centres strongly support the use of an EIS in the elderly, showing a significantly larger absolute reduction in 30-day major adverse clinical events in elderly patients than that in younger patients, and prompt the need for dedicated randomized trials.
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Liïstro et al. (2005) conducted a review in non-ST-elevation acute coronary syndromes. Early invasive strategy was evaluated on 30-day major adverse clinical events. Recent clinical data support the use of an early invasive strategy in elderly patients with acute coronary syndromes, showing a larger absolute reduction in 30-day major adverse clinical events.
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