Coronary disease & ACSRandomised controlled trial
Long-Term Outcomes of Invasive vs Conservative Strategies for Older Patients With Non–ST-Segment Elevation Acute Coronary Syndromes
- Randomised controlled trial
- long-term follow-up
Authors' conclusion
In patients aged ≥80 years with NSTE-ACS, the invasive strategy was superior to the conservative strategy in the reduction of composite events and demonstrated a significant gain in event-free survival.
Study context
- Population
- Patients aged ≥80 years with NSTE-ACS (mean age 85 years), randomised 2010–2014
- Participants
- 457 patients
- Comparison
- Invasive vs conservative strategy
- Primary endpoint
- Composite of:
- MI
- Need for urgent revascularization
- Stroke
- Death
- Follow-up
- Median 5.3 years
Primary result
As reported in the abstract
Incidence rate ratio
0.76
95% CI 0.63–0.93
P = 0.0057
Invasive vs Conservative
incidence rate ratio 0.76 (95% CI 0.63–0.93); P = 0.0057
Further findings
| Outcome | gain in event-free survival (days) (95% CI) | P value |
|---|---|---|
| Gain in event-free survival — Invasive vs Conservative · at 5 years | 276 (151–400) | P = 0.0001 |
| Gain in event-free survival — Invasive vs Conservative · at 10 years | 337 (123–550) | P = 0.0001 |
Primary endpoint by subgroups (major CV prognostic factors)
- Results consistent across subgroups
Original publication
Long-Term Outcomes of Invasive vs Conservative Strategies for Older Patients With Non–ST-Segment Elevation Acute Coronary Syndromes. J Am Coll Cardiol. Published 21 November 2023. doi:10.1016/j.jacc.2023.09.809
Summarised from the published abstract; every number is checked against it