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https://www.rpr.lib.ok.us/taxonomy/term/11470/all
enInvasive Versus Conservative Treatment Strategy in Older Patients With Non-ST Segment Elevation Acute Coronary Syndromes: A Meta-Analysis of Randomized Controlled Trials
https://www.rpr.lib.ok.us/resource/invasive-versus-conservative-treatment-strategy-older-patients-non-st-segment-elevation
<div class="field field-name-field-artifact-uploaded-date field-type-datetime field-label-inline clearfix">
<div class="field-label">Date Added: </div>
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<div class="field-item even"><span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2025-03-31T00:00:00-05:00">March 31, 2025</span></div>
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<div class="field field-name-field-artifact-journal field-type-text field-label-inline clearfix">
<div class="field-label">Journal/Publication: </div>
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<div class="field-item even">J Am Geriatr Soc .</div>
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<div class="field field-name-field-artifact-published-date field-type-datetime field-label-inline clearfix">
<div class="field-label">Publication Date: </div>
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<div class="field-item even"><span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2025-03-26T00:00:00-05:00">March 26, 2025</span></div>
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<div class="field field-name-field-artifact-url field-type-link-field field-label-inline clearfix">
<div class="field-label">URL: </div>
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<div class="field-item even"><a href="https://pubmed.ncbi.nlm.nih.gov/40135822/" target="_blank">Invasive Versus Conservative Treatment Strategy in Older Patients With Non-ST Segment Elevation Acute Coronary Syndromes: A Meta-Analysis of Randomized Controlled Trials</a></div>
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<div class="field field-name-field-artifact-type field-type-taxonomy-term-reference field-label-inline clearfix">
<div class="field-label">Type: </div>
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<div class="field-item even">Meta-analyses, Reviews, and Guidelines</div>
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<div class="field field-name-field-artifact-format field-type-taxonomy-term-reference field-label-inline clearfix">
<div class="field-label">Format: </div>
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<div class="field-item even">Article</div>
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<div class="field field-name-field-artifact-doi-1 field-type-text field-label-inline clearfix">
<div class="field-label">DOI (1): </div>
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<div class="field-item even">10.1111/jgs.19447</div>
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<div class="field field-name-field-artifact-keywords field-type-taxonomy-term-reference field-label-above">
<div class="field-label">Keywords </div>
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<div class="field-item even"><a href="/tags/nstemi" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">NSTEMI</a></div>
<div class="field-item odd"><a href="/tags/conservative-treatment" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Conservative treatment</a></div>
<div class="field-item even"><a href="/tags/invasive-treatment" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">invasive treatment</a></div>
<div class="field-item odd"><a href="/tags/revascularization" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">revascularization</a></div>
<div class="field-item even"><a href="/tags/unstable-angina-pectoris" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">unstable angina pectoris</a></div>
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<div class="field field-name-field-artifact-pmid-1 field-type-text field-label-inline clearfix">
<div class="field-label">PMID (1): </div>
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<div class="field-item even">40135822</div>
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<div class="field field-name-field-artifact-mesh field-type-taxonomy-term-reference field-label-above">
<div class="field-label">MeSH </div>
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<div class="field-item even"><a href="/mesh/acute-coronary-syndrome" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">acute coronary syndrome</a></div>
<div class="field-item odd"><a href="/mesh/conservative-treatment" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">conservative treatment</a></div>
<div class="field-item even"><a href="/mesh/myocardial-infarction" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">myocardial infarction</a></div>
<div class="field-item odd"><a href="/mesh/stroke" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">stroke</a></div>
</div>
</div>
<div class="field field-name-field-artifact-editor-note field-type-text-long field-label-hidden">
<div class="field-items">
<div class="field-item even"><p>Revascularization may reduce subsequent MI and invasive procedures but not mortality compared to conservative care in older patients following non-ST elevation MI. James W. Mold, MD, MPH</p>
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<div class="field field-name-field-artifact-text-availability field-type-list-text field-label-hidden">
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<div class="field-item even">Free full text</div>
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<div class="field-item even"><div class="view view-artifact-docs view-id-artifact_docs view-display-id-block view-dom-id-d6a63f39fe3aba1df9a5ad4103f71760">
<div class="view-content">
<div class="views-row views-row-1 views-row-odd views-row-first views-row-last">
<a href="https://pubmed.ncbi.nlm.nih.gov/40135822/" class="btn btn-primary" target="_blank">View</a> </div>
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</div></div>
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<div class="field field-name-body field-type-text-with-summary field-label-hidden">
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<div class="field-item even" property="content:encoded"><p>Background<br />
Non-ST segment elevation acute coronary syndromes (NSTE-ACS) are a common cause of hospital admission in older patients. Our study aims to synthesize the available evidence from randomized controlled trials (RCTs) to compare clinical outcomes with invasive versus conservative medical management in this population.</p>
<p>Methods<br />
A literature search of online databases including PubMed/MEDLINE, Embase, and the Cochrane Library was conducted from inception to September 1, 2024. The search aimed to identify RCTs that reported clinical outcomes with invasive versus conservative strategies in older patients (≥ 70 years) with NSTE-ACS. The risk ratios (RRs) were used as summary estimates.</p>
<p>Results<br />
Seven RCTs with 2998 patients were included; 1490 patients in the invasive group and 1508 patients in the conservatively managed group. The pooled analysis demonstrated no statistically significant difference between the two strategies for the risk of all-cause death (RR: 1.03, 95% CI: 0.92–1.15), cardiovascular death (RR: 1.04, 95% CI: 0.82–1.33), stroke (RR: 0.78, 95% CI: 0.53–1.15), and major bleeding (RR: 1.23, 95% CI: 0.90–1.69). However, the invasive strategy was associated with a significantly reduced risk of myocardial infarction (RR: 0.74, 95% CI: 0.57–0.96) and unplanned revascularization (RR: 0.29, 95% CI: 0.21–0.40) compared to the conservative strategy.</p>
<p>Conclusion<br />
In older patients with NSTE-ACS, an invasive strategy reduces the risk of repeat myocardial infarction and unplanned revascularization without a significant increase in stroke or major bleeding. There was no associated reduction in all-cause or cardiovascular mortality with the invasive strategy compared to conservative management.</p>
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<div class="field field-name-field-resource-author field-type-taxonomy-term-reference field-label-inline clearfix">
<div class="field-label">Author/s: </div>
<div class="field-items">
<div class="field-item even">Mushood Ahmed, Areeba Ahsan, Aimen Shafiq, Tallal Mushtaq Hashmi</div>
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Mon, 31 Mar 2025 13:51:29 +0000Alex Haga2597 at https://www.rpr.lib.ok.us