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dc.contributor.authorBerg, Erlend
dc.contributor.authorTegn, Nicolai Kloumann
dc.contributor.authorAbdelnoor, Michael
dc.contributor.authorRyalen, Pål Christie
dc.contributor.authorRøysland, Kjetil
dc.contributor.authorAaberge, Lars
dc.contributor.authorEek, Christian
dc.contributor.authorØie, Erik Harald
dc.contributor.authorJuliebø, Vibeke
dc.contributor.authorGjertsen, Erik
dc.contributor.authorRanhoff, Anette Hylen
dc.contributor.authorGullestad, Lars
dc.contributor.authorNordstrand, Njord
dc.contributor.authorBendz, Bjørn
dc.description.abstractBackground 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.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internasjonal*
dc.titleLong-Term Outcomes of Invasive vs Conservative Strategies for Older Patients With Non–ST-Segment Elevation Acute Coronary Syndromesen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.source.journalJournal of the American College of Cardiologyen_US
dc.identifier.citationJournal of the American College of Cardiology. 2023, 82 (21), 2021-2030.en_US

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Attribution-NonCommercial-NoDerivatives 4.0 Internasjonal
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