Invasive vs. conservative management of older patients with non-ST-elevation acute coronary syndrome: individual patient data meta-analysis
Pooled resultResult — go to the resultHazard ratio 0.87 95% CI 0.63–1.22Authors' conclusion
No evidence was found that routine invasive treatment for NSTEACS in older patients reduces the risk of a composite of all-cause mortality and MI within 1 year compared with conservative management. However, there is convincing evidence that invasive treatment significantly lowers the risk of repeat MI or urgent revascularisation.
Study context
- Population
- Persons >70 years old with non-ST-elevation acute coronary syndrome (NSTEACS)
- Participants
- 1,479 persons6 randomized controlled trials (RCTs)
- Comparison
- Routine invasive vs conservative management
- Invasiven = 736
- Conservativen = 743reference
- Outcome
- Composite of:
- All-cause mortality
- MI
- Follow-up
- 1 year
Methodological detailsone-stage individual patient data (IPD) meta-analysis, random-effects and fixed-effect Cox models
- One-stage IPD meta-analysis
- Random-effects and fixed-effect Cox models
Pooled result
As reported in the abstract
Hazard ratio
0.87
95% CI 0.63–1.22
P = 0.43
Events by group
Invasivevs Conservative
HR 0.87 (95% CI 0.63–1.22); P = 0.43
Further pooled results
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| MI · 1 yearRandom-effects model | 0.62 (0.44–0.87) | P = 0.006 | |
| 0.512Hazard ratio (log scale) |
Urgent revascularization
- Urgent revascularization lower with invasive vs conservative (HR, random-effects model)
- 0.41
- 95% CI
- 0.18-0.95
- P
- P = 0.037
Mortality
- No significant difference in mortality
Original publication
Invasive vs. conservative management of older patients with non-ST-elevation acute coronary syndrome: individual patient data meta-analysis. Eur Heart J. Published 10 April 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →