No difference in invasive strategy or medical management for older, frail patients with NSTEMI

Clinical Question

Does a routine invasive strategy produce better outcomes than medical management in older, frail patients with non-ST segment elevation myocardial infarction?

Bottom line

In this study of older patients with frailty who present with NSTEMI, a routine invasive strategy was no different than medical therapy in improving outcomes. However, there were a few limitations to this study, including lack of full power, a potential selection bias, and baseline characteristics between the study groups that were not completely balanced. A larger randomized trial is needed to determine whether medical management alone is adequate in these patients. 1b-

Study design: Randomized controlled trial (nonblinded)

Funding: Government

Setting: Inpatient (any location) with outpatient follow-up

Reviewer

Nita Shrikant Kulkarni, MD
Assistant Professor in Hospital Medicine
Northwestern University
Chicago, IL


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Comments

ARUP KUMAR DHARA

Impact assessment

Excellent

Anonymous

NSTEMI vs medical management in elderly

This is too small and potentially biased study ( statistically ) to draw a practice altering solution from . A larger study is required .

Anonymous

No

No

Anonymous

yet another study suggesting that invasive therapy is not th

difficult to convince the cardiologists that what they are doing does not make sense