After Eighty: Comparision of Cardiac Events in Older Acute STEMI Patients

Acute coronary syndrome (ACS) patients over the age of 80 may benefit from aggressive, invasive treatments and tests, which may have been unnecessarily denied to them due to age, according to research from the “After Eighty Study” presented Monday, March 16 as part of ACC.15 and simultaneously published in the New England Journal of Medicine.

The study was conducted in 16 health facilities across Norway, by Nicolai Tegn, MD, and team, using a randomized 1:1 trial and included 458 patients receiving treatment for non ST-elevation myocardial infarction (NSTEMI) or unstable angina. Patients were either selected to receive a conservative protocol of drug therapy, or coronary angiography—a more invasive approach—to determine which course of treatment would result in the best clinical outcomes.

Patients who received the more invasive procedure were 47 percent more likely to see a reduction in negative outcomes than the group of patients who received drug therapy. Results indicated that age should not be prohibitive when it comes to recommending an invasive course of treatment.

“Because people over 80 are underrepresented in clinical trials, they are less likely to receive treatment according to guidelines,” said Tegn. “Our study, which directly targets the over-80 population, is the first to demonstrate that a more invasive strategy results in better outcomes in these patients. I believe our study provides a sufficient basis to recommend an invasive approach.”

For those interested in learning more about treating the geriatric population, check out the Geriatric Clinical Topic Hub on ACC.org and the join the ACC’s Geriatric Cardiology Member Section to connect with like-minded professionals and serve as a voice for geriatric specialists within the College.

Clinical Topics: Acute Coronary Syndromes, Cardiac Surgery, Geriatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Cardiac Surgery and SIHD, Interventions and ACS, Interventions and Imaging, Angiography, Nuclear Imaging

Keywords: ACC Annual Scientific Session, Acute Coronary Syndrome, Aged, 80 and over, Angina Pectoris, Angina, Unstable, Coronary Angiography, Coronary Artery Bypass, Follow-Up Studies, Geriatrics, Incidence, Myocardial Infarction, Cardiovascular Meetings


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