For Older Adults with NSTEMI, Is Invasive Treatment Warranted?

Invasive and conservative strategies had similar outcomes in a randomized trial involving patients age 75 years or older with non–ST-segment elevation myocardial infarction.

Optimal management of non–ST-segment elevation myocardial infarction (NSTEMI) in older patients is unknown because they are underrepresented in clinical trials. Investigators with the SENIOR-RITA trial have now compared conservative management (best available medical therapy alone) with an invasive strategy (coronary angiography and, as appropriate, revascularization; plus medical therapy) in a randomized trial involving 1518 patients aged ≥75 years (mean age, 82; 45% women; 32% frail) with NSTEMI at 48 sites in the UK. More than 80% of patients in each group were on dual antiplatelet therapy; more than 10% were on triple therapy (dual antiplatelet plus anticoagulation).

Of the invasively managed group, roughly 90% had a successful radial-ar…

Reviewing Author

Shea E. Hogan, MD, MSCS, FACC, FSCAI, FSVM

Disclosures

Editorial BoardsVascular Medicine

Shea E. Hogan, MD, MSCS, FACC, FSCAI, FSVM

Disclosures

Editorial BoardsVascular Medicine

For Older Adults with NSTEMI, Is Invasive Treatment Warranted?

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Reviewing Author