September 19, 2011Heart130 citations
View Full PaperEffects of age on long-term outcomes after a routine invasive or selective invasive strategy in patients presenting with non-ST segment elevation acute coronary syndromes: a collaborative analysis of individual data from the FRISC II - ICTUS - RITA-3 (FIR) trials
Structured PICO
Does a routine invasive strategy improve long-term outcomes compared to a selective invasive strategy in patients presenting with non-ST segment elevation acute coronary syndromes?
P
Population
Patients presenting with non-ST segment elevation acute coronary syndromes (NSTE-ACS) from the FRISC II, ICTUS, and RITA-3 trials
I
Intervention
Routine invasive strategy
C
Comparator
Selective invasive strategy
O
Outcome
Long-term outcomes including long-term cardiovascular mortalityhard clinical
The long-term benefit of a routine invasive strategy in NSTE-ACS is attenuated in patients <65 years and women due to early events, though without consequence for long-term cardiovascular mortality.
Abstract
The current analysis of the FIR dataset shows that the long-term benefit of the routine invasive strategy over the selective invasive strategy is attenuated in younger patients aged <65 years and in women by the increased risk of early events which seem to have no consequences for long-term cardiovascular mortality. No other clinical risk factors were able to identify patients with differential responses to a routine invasive strategy. Trial registration http://www.controlled-trials.com/ISRCTN82153174 (ICTUS), http://www.controlled-trials.com/ISRCTN07752711 (RITA-3).