Evaluating the outcomes of invasive versus conservative strategies in older patients with non-ST elevation myocardial infarction.

This study evaluated the outcomes of invasive versus conservative strategies in patients older than 70 years with non-ST elevation myocardial infarction (NSTEMI). The data showed that an initial invasive strategy was associated with a significantly lower risk of major cardiac and cerebrovascular events and unplanned revascularization compared to a conservative strategy without increased bleeding in these patients.

Coronary artery disease (CAD) is caused by reduced blood flow to the heart. This can be caused by blockages. CAD can lead to a heart attack. Myocardial infarction (MI) is the medical term for a heart attack. An electrocardiogram (ECG) is used to detect an MI. One type of MI is called non-ST elevation MI (NSTEMI). NSTEMI can be managed using invasive or non-invasive strategies. Invasive management involves surgical procedures. The aim of this is to remove any clots in the arteries.

Non-invasive management is another option. This can involve medications to reduce the risk of another MI. This can be achieved by lowering blood pressure or taking blood-thinning medication. Studies have compared invasive and non-invasive in patients with NSTEMI. However, these studies only included younger patients and did not include patients over the age of 70. It is important to evaluate the outcomes of invasive versus conservative strategies in older patients with NSTEMI.

This study analyzed 4 other studies and involved a total of 1126 patients with NSTEMI. All patients were aged 70 years or older. 559 patients received an invasive strategy. 567 patients received a conservative strategy. The average follow-up period was 1.25 years.

The invasive strategy was associated with a significantly lower risk (by 40%) of major cardiac and cerebrovascular events compared to the conservative strategy.

The invasive strategy was associated with a significantly lower risk (by 69%) of unplanned revascularization compared to the conservative strategy.

There was no significant difference in all-cause mortality, myocardial infarction, or bleeding between the two strategies.

This study concluded that an initial invasive strategy was associated with a significantly lower risk of major cardiac and cerebrovascular events and unplanned revascularization compared to a conservative strategy without increased bleeding in older patients with NSTEMI.

This study looked back in time at medical records. The number of studies analyzed was very small. This study did not include individual patient data. This study did not evaluate the long-term outcomes.