LAUSR

BACKGROUND There is a paucity of data if there is a benefit for patients above 80 years of age with non-ST-segment elevation myocardial infarction (NSTEMI) to undergo percutaneous coronary intervention (PCI). OBJECTIVES To investigate the association between PCI or conservative treatment and outcomes in NSTEMI patients above 80 years of age. METHODS From the SWEDEHEART register were included 13,854 patients above 80 years of age with NSTEMI during 2011-2014 in Sweden. Cox regression was used to calculate hazard ratios (HR) with 95% confidence intervals (CI) for the association between PCI compared with conservative treatment for the outcome all-cause mortality. RESULTS In total 4158 (30%) patients underwent PCI, and 9696 (70%) were treated conservatively. The mean age was 86 (±4) years. During a mean 2.2 (±1.4) years there were 6458 (47%) deaths, where of 1078 (26%) in PCI treated, and 5380 (56%) in conservatively treated patients. Treatment with PCI compared with conservative treatment was associated with a 40% lower risk of death (adjusted HR 0.60, 95% CI 0.55-0.66). Similarly, patients in the PCI group had a 60% lower 30-day, and 51% lower 1-year all-cause mortality, respectively (adjusted HR 0.40, 95% CI 0.25-0.63, and HR, 0.49 95% CI 0.42-0.57, respectively). There were no differences in risk of bleedings (1.4% versus 1.3%). CONCLUSIONS PCI compared with conservative treatment was associated with a lower mortality in patients above 80 years of age with NSTEMI without an increased risk of bleedings. PCI may be considered as the treatment of choice for elderly with NSTEMI.