dc.contributor.author | Berg, Erlend | |
dc.contributor.author | Tegn, Nicolai Kloumann | |
dc.contributor.author | Abdelnoor, Michael | |
dc.contributor.author | Ryalen, Pål Christie | |
dc.contributor.author | Røysland, Kjetil | |
dc.contributor.author | Aaberge, Lars | |
dc.contributor.author | Eek, Christian | |
dc.contributor.author | Øie, Erik Harald | |
dc.contributor.author | Juliebø, Vibeke | |
dc.contributor.author | Gjertsen, Erik | |
dc.contributor.author | Ranhoff, Anette Hylen | |
dc.contributor.author | Gullestad, Lars | |
dc.contributor.author | Nordstrand, Njord | |
dc.contributor.author | Bendz, Bjørn | |
dc.date.accessioned | 2024-03-11T09:19:57Z | |
dc.date.available | 2024-03-11T09:19:57Z | |
dc.date.created | 2023-11-15T11:16:31Z | |
dc.date.issued | 2023 | |
dc.identifier.issn | 0735-1097 | |
dc.identifier.uri | https://hdl.handle.net/11250/3121722 | |
dc.description.abstract | Background
Non–ST-segment elevation acute coronary syndrome (NSTE-ACS) is a frequent cause of hospital admission in older people, but clinical trials targeting this population are scarce.
Objectives
The After Eighty Study assessed the effect of an invasive vs a conservative treatment strategy in a very old population with NSTE-ACS.
Methods
Between 2010 and 2014, the investigators randomized 457 patients with NSTE-ACS aged ≥80 years (mean age 85 years) to an invasive strategy involving early coronary angiography with immediate evaluation for revascularization and optimal medical therapy or to a conservative strategy (ie, optimal medical therapy). The primary endpoint was a composite of myocardial infarction, need for urgent revascularization, stroke, and death. The long-term outcomes are presented.
Results
After a median follow up of 5.3 years, the invasive strategy was superior to the conservative strategy in the reduction of the primary endpoint (incidence rate ratio: 0.76; 95% CI: 0.63-0.93; P = 0.0057). The invasive strategy demonstrated a significant gain in event-free survival of 276 days (95% CI: 151-400 days; P = 0.0001) at 5 years and 337 days (95% CI: 123-550 days; P = 0.0001) at 10 years. These results were consistent across subgroups of patients with respect to major cardiovascular prognostic factors.
Conclusions
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. (The After Eighty Study: a randomized controlled trial; NCT01255540) | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Elsevier | en_US |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/deed.no | * |
dc.title | Long-Term Outcomes of Invasive vs Conservative Strategies for Older Patients With Non–ST-Segment Elevation Acute Coronary Syndromes | en_US |
dc.type | Journal article | en_US |
dc.type | Peer reviewed | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | Copyright 2023 The Author(s) | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 2 | |
dc.identifier.doi | 10.1016/j.jacc.2023.09.809 | |
dc.identifier.cristin | 2196957 | |
dc.source.journal | Journal of the American College of Cardiology | en_US |
dc.source.pagenumber | 2021-2030 | en_US |
dc.identifier.citation | Journal of the American College of Cardiology. 2023, 82 (21), 2021-2030. | en_US |
dc.source.volume | 82 | en_US |
dc.source.issue | 21 | en_US |