The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Editorial

Early invasive approach and outcome in elderly patients with NSTEACS: randomised trials, real-world data and guideline recommendations

EuroIntervention 2021;17:20-21. DOI: 10.4244/EIJV17I1A4

1. Cardiovascular Department, Manzoni Hospital, Lecco, Italy; 2. University of Pavia, Pavia, Italy
Patients older than 75 years represent about 40% of coronary care unit admissions with non-ST-elevation acute coronary syndromes (NSTEACS)1; however, they have been underrepresented in randomised clinical trials (RCTs). Only during the last decade have dedicated RCTs compared an early invasive (EI) with an initially conservative (IC) approach in elderly patients2,3,4. The first of these, the Italian Elderly ACS randomised trial, enrolled 313 NSTEACS patients aged ≥75 years and found a reduction with EI treatment in the composite primary 12-month endpoint (mortality, non-fatal myocardial infarction [MI], disabling stroke and readmission for cardiovascular causes or bleeding) in patients with elevated troponin (Tn) levels (60% of ...

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