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Abstract
We evaluated the 3-year clinical outcomes following early invasive (EI) and delayed invasive (DI) strategies in older adults with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing successful new-generation drug-eluting stents (DESs) implantation to reflect current real-world practice. Overall, 2437 older adults (age, ≥ 65 years) with NSTEMI were recruited from the Korea Acute Myocardial Infarction Registry-National Institute of Health. They were divided into two groups: EI (n = 1750) and DI (n = 687). The primary clinical outcome was the occurrence of major adverse cardiac and cerebrovascular events (MACCEs), defined by all-cause death, recurrent MI, any repeat coronary revascularization, and stroke. The secondary clinical outcome was stent thrombosis (ST). After multivariable-adjusted and propensity score-matched analyses, the primary and secondary clinical outcomes were not significantly different between the EI and DI groups. Even after the analysis was confined to those having complex lesions, these major clinical outcomes were similar between these two groups. The EI and DI strategies in older adults with NSTEMI receiving new-generation DES showed comparable results.
Clinical Trial Registration: URL: http://cris.nih.go.kr/cris/en/; Unique identifier: KCT0000863.
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1 Kangwon National University School of Medicine, Division of Cardiology, Department of Internal Medicine, Chuncheon, Republic of Korea (GRID:grid.412010.6) (ISNI:0000 0001 0707 9039)
2 Korea University Guro Hospital, Cardiovascular Center, Seoul, Republic of Korea (GRID:grid.411134.2) (ISNI:0000 0004 0474 0479)
3 Cardiovascular Research Institute, Korea University College of Medicine, Seoul, Republic of Korea (GRID:grid.222754.4) (ISNI:0000 0001 0840 2678)
4 Nowon Eulji Medical Center, Eulji University, Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul, Republic of Korea (GRID:grid.255588.7) (ISNI:0000 0004 1798 4296)
5 Soonchunhyang University Cheonan Hospital, Cardiology Department, Cheonan, Republic of Korea (GRID:grid.412677.1) (ISNI:0000 0004 1798 4157)
6 Chonnam National University Hospital, Department of Cardiology, Cardiovascular Center, Gwangju, Republic of Korea (GRID:grid.411597.f) (ISNI:0000 0004 0647 2471)