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Deciding whether an older patient should receive invasive or conservative treatment for non–ST-segment elevation myocardial infarction (NSTEMI) is a longstanding challenge. To strengthen the available evidence comparing outcomes with both approaches, researchers pooled findings from 7 randomized, controlled trials among 3000 patients aged ≥70 years with NSTEMI. Their mean age was 83 years.
During an average follow-up of 4 years, they found:
No significant difference in all-cause mortality with an invasive versus conservative management approach (28% vs. 27%)
No difference in cardiovascular mortality, acute cerebrovascular events, or length of hospital stay
A nonsignificant trend toward fewer major adverse cardiac events in the invasively manage…