RT Journal Article
SR Electronic
T1 Patients aged 80 years or older with non-ST-elevation myocardial infarction or unstable angina pectoris randomised to an invasive versus conservative strategy: angiographic and procedural results from the After Eighty study
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e001256
DO 10.1136/openhrt-2020-001256
VO 7
IS 2
A1 Nicolai Tegn
A1 Christian Eek
A1 Michael Abdelnoor
A1 Lars Aaberge
A1 Knut Endresen
A1 Rita Skårdal
A1 Erlend Sturle Berg
A1 Lars Gullestad
A1 Bjørn Bendz
YR 2020
UL http://openheart.bmj.com/content/7/2/e001256.abstract
AB Objectives We aimed to report the angiographic and procedural results of the After Eighty study (ClinicalTrials.gov, NCT01255540), and to identify independent predictors of revascularisation.Methods Patients of ≥80 years old with non-ST-elevation myocardial infarction and unstable angina pectoris were randomised to an invasive or conservative strategy. Angiographic and procedural results were recorded. Univariate and multivariate analyses were performed to explore variables predicting revascularisation.Results Among 229 patients in the invasive group, 220 underwent immediate coronary angiography (90% performed via the radial artery). Of these patients, 48% had three-vessel disease or left main stenosis, 18% two-vessel disease, 16% one-vessel disease, 17% minor coronary vessel wall changes and two patients had normal coronary arteries. Six patients (3%) underwent coronary artery bypass graft. Percutaneous coronary intervention (PCI) was performed in 107 patients (49%), with 57% treated with bare metal stents, 37% drug-eluting stents and 6% balloon angioplasty. On average, 1.7 lesions were treated and 2 stents delivered per patient. Complications included 1 major PCI-related bleeding (successfully treated), 2 minor access site-related bleedings, 3 side branch occlusions during PCI and 11 periprocedural myocardial infarctions (considered end points). Sex, bundle branch block and smoking were independent predictors of revascularisation.Conclusions PCI was performed in approximately half of the patients, similar to findings in younger populations. Procedural success was high, with few complications.Trial registration number NCT01255540