NSTEMI Management in Frail Older Adults: Is Less More?

Frail older adults have a worse prognosis after acute coronary syndromes, yet reliable data have been lacking to determine their optimal management. The recent SENIOR-RITA trial was the first large randomized, controlled trial to assess outcomes in an older population with non–ST-segment myocardial infarction (NSTEMI), comparing an invasive strategy (coronary angiography, revascularization if needed, and optimal medical therapy) with medical therapy alone in patients aged ≥75 years. The investigators now report findings in a subgroup of 470 patients with frailty (roughly one third of the trial cohort); their median age was 83 years.