Early invasive versus non-invasive treatment in patients with non-ST-elevation acute coronary syndrome (FRISC-II): 15 year follow-up of a prospective, randomised, multicentre study

Wallentin, Lars; Lindhagen, Lars; Ärnström, Elisabet; Husted, Steen; Janzon, Magnus; Johnsen, Søren Paaske; Kontny, Frederic; Kempf, Tibor; Levin, Lars‐Åke; Lindahl, Bertil; Stridsberg, Mats; Ståhle, Elisabeth; Venge, Per; Wollert, Kai C.; Swahn, Eva; Lagerqvist, Bo

doi:10.1016/s0140-6736(16)31276-4

Cited by 75 publications

(52 citation statements)

References 29 publications

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“…It is possible that such higher risk cases of AMI require more intensive and persistent or novel therapeutic interventions to achieve ongoing equipoise in outcomes between the sexes. 34,35 We also found that excess mortality increased with increasing age. This was evident both for STEMI and NSTEMI in women >85 years, with >2-fold higher excess mortality than their younger counterparts.…”

Section: Discussionmentioning

confidence: 53%

“…For NSTEMI, the differences in excess mortality were mitigated after adjustment for the use of treatments at up to, but not beyond 1 year following hospitalization. It is possible that such higher risk cases of AMI require more intensive and persistent or novel therapeutic interventions to achieve ongoing equipoise in outcomes between the sexes 34, 35…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Sex Differences in Treatments, Relative Survival, and Excess Mortality Following Acute Myocardial Infarction: National Cohort Study Using the SWEDEHEART Registry

Alabas

Gale

Hall

et al. 2017

JAHA

Self Cite

148

122

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BackgroundThis study assessed sex differences in treatments, all‐cause mortality, relative survival, and excess mortality following acute myocardial infarction.Methods and ResultsA population‐based cohort of all hospitals providing acute myocardial infarction care in Sweden (SWEDEHEART [Swedish Web System for Enhancement and Development of Evidence‐Based Care in Heart Disease Evaluated According to Recommended Therapies]) from 2003 to 2013 was included in the analysis. Excess mortality rate ratios (EMRRs), adjusted for clinical characteristics and guideline‐indicated treatments after matching by age, sex, and year to background mortality data, were estimated. Although there were no sex differences in all‐cause mortality adjusted for age, year of hospitalization, and comorbidities for ST‐segment–elevation myocardial infarction (STEMI) and non‐STEMI at 1 year (mortality rate ratio: 1.01 [95% confidence interval (CI), 0.96–1.05] and 0.97 [95% CI, 0.95–0.99], respectively) and 5 years (mortality rate ratio: 1.03 [95% CI, 0.99–1.07] and 0.97 [95% CI, 0.95–0.99], respectively), excess mortality was higher among women compared with men for STEMI and non‐STEMI at 1 year (EMRR: 1.89 [95% CI, 1.66–2.16] and 1.20 [95% CI, 1.16–1.24], respectively) and 5 years (EMRR: 1.60 [95% CI, 1.48–1.72] and 1.26 [95% CI, 1.21–1.32], respectively). After further adjustment for the use of guideline‐indicated treatments, excess mortality among women with non‐STEMI was not significant at 1 year (EMRR: 1.01 [95% CI, 0.97–1.04]) and slightly higher at 5 years (EMRR: 1.07 [95% CI, 1.02–1.12]). For STEMI, adjustment for treatments attenuated the excess mortality for women at 1 year (EMRR: 1.43 [95% CI, 1.26–1.62]) and 5 years (EMRR: 1.31 [95% CI, 1.19–1.43]).ConclusionsWomen with acute myocardial infarction did not have statistically different all‐cause mortality, but had higher excess mortality compared with men that was attenuated after adjustment for the use of guideline‐indicated treatments. This suggests that improved adherence to guideline recommendations for the treatment of acute myocardial infarction may reduce premature cardiovascular death among women.Clinical Trial RegistrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT02952417.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Sex Differences in Treatments, Relative Survival, and Excess Mortality Following Acute Myocardial Infarction: National Cohort Study Using the SWEDEHEART Registry

Alabas

Gale

Hall

et al. 2017

JAHA

Self Cite

148

122

View full text Add to dashboard Cite

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“…Clinical implications: Recently, several reports on 10- year follow-up outcomes of ACS have been published. [16][17][18] However, little information is available about predictors of adverse events beyond 5 years after index presentation of ACS. In the present study, age > 65 and positive troponin T at acute presentation were significant predictors of MACCEs beyond the final CAG.…”

Section: Discussionmentioning

confidence: 99%

Impact of the Temporal Distribution of Coronary Artery Disease Progression on Subsequent Consequences in Patients with Acute Coronary Syndrome

Nakatani¹,

Fukui

Kato

et al. 2019

Int. Heart J.

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The late consequences of acute coronary syndrome (ACS) have been underestimated. We hypothesized that the temporal distribution of the clinically silent coronary artery disease progression (CP) is associated with the subsequent consequences of ACS.We studied 243 patients (202 men, 64 10 years) with ACS undergoing percutaneous coronary intervention (PCI) during initial hospitalization. All patients underwent serial coronary angiograms (CAGs) immediately before PCI and at 7 3 and 60 10 months after presentation. CP was defined as an increase !15% in stenosis severity of the lesion between 2 serial CAGs. The impact of CP between each 2 serial CAGs on subsequent major adverse cardiovascular and cerebrovascular events (MACCEs) after the final CAG was examined using multivariate Cox and propensity-matched analyses.During the median follow-up duration after the final CAG of 67 months, 76 MACCEs (31.3%) were observed. Multivariate Cox proportional hazards analysis revealed that CP between the first and second CAGs (hazard ratio [HR], 2.28; 95% confidence interval [CI], 1.32-3.94; P = 0.003) and CP between the second and final CAGs (HR, 1.96; 95% CI, 1.20-3.21; P = 0.008) were independently associated with a higher rate of MACCEs beyond the final CAG. Consistent results were obtained in the propensity score-matched analyses.CP in both the early (0-7 months) and late phases (7-60 months) were independently associated with subsequent clinical events. This may indicate the prognostic significance of persistent widespread coronary disease activity following presentation in patients with ACS undergoing PCI.(Int Heart J 2019; 60: 287-295)

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“…In the control group all the trials used standard medical treatment [12][13][14][15][16][17]. In the treatment arm, four trials specified the time to intervention (4-72 hours) [12,14,15,16].…”

Section: Description Of Studiesmentioning

confidence: 99%

A systematic review and meta-analysis on the effectiveness of an invasive strategy compared to a conservative approach in patients > 65 years old with non-ST elevation acute coronary syndrome

et al. 2020

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Background Patients 65 years old and older largely represent (>50%) hospital-admitted patients with acute coronary syndrome (ACS). Data are conflicting comparing efficacy of early routine invasive (within 48-72 hours of initial evaluation) versus conservative management of ACS in this population. Objective We aimed to determine the effectiveness of routine early invasive strategy compared to conservative treatment in reducing major adverse cardiovascular events in patients 65 years old and older with non-ST elevation (NSTE) ACS. Data sources We conducted a systematic review of randomized controlled trials (RCTs) through PubMed, Cochrane, and Google Scholar database. Study selection The studies included were RCTs that evaluated the effectiveness of invasive strategy compared to conservative treatment among patients � 65 years old diagnosed with NSTEACS. Studies were included if they assessed any of the following outcomes of death, cardiovascular mortality, myocardial infarction (MI), stroke, recurrent angina, and need for revascularization. Six articles were subsequently included in the meta-analysis.

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Early invasive versus non-invasive treatment in patients with non-ST-elevation acute coronary syndrome (FRISC-II): 15 year follow-up of a prospective, randomised, multicentre study

Cited by 75 publications

References 29 publications

Sex Differences in Treatments, Relative Survival, and Excess Mortality Following Acute Myocardial Infarction: National Cohort Study Using the SWEDEHEART Registry

Sex Differences in Treatments, Relative Survival, and Excess Mortality Following Acute Myocardial Infarction: National Cohort Study Using the SWEDEHEART Registry

Impact of the Temporal Distribution of Coronary Artery Disease Progression on Subsequent Consequences in Patients with Acute Coronary Syndrome

A systematic review and meta-analysis on the effectiveness of an invasive strategy compared to a conservative approach in patients > 65 years old with non-ST elevation acute coronary syndrome

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