Some Older Heart Patients Might Benefit From Aggressive Treatments
Those who suffered milder type of heart attack or unstable chest pain did worse if only given medication
MONDAY, March 16, 2015 (HealthDay News) -- Older people with certain types of heart problems might benefit from aggressive treatment they might otherwise not receive because of their age, a new study suggests.
Researchers looked at 458 patients, aged 80 and older, in Norway who had a type of heart attack that is initially mild but leads to poor outcomes after six months or longer, or a closely related condition called unstable angina.
Both conditions -- called acute coronary syndromes -- are caused by plaque buildup in the heart's arteries.
The patients were randomly assigned to receive either conservative treatment -- which included medications but no invasive procedures -- or to undergo coronary angiography, in which a catheter is threaded into the heart's arteries to assess them.
Of the patients who had coronary angiography, 48 percent later had balloon angioplasty and/or stenting to widen narrowed arteries and keep them open, and 3 percent had heart bypass surgery, according to the report.
Over an average follow-up of 18 months, those who received more aggressive treatment were 47 percent less likely to have a heart attack, require emergency procedures to open clogged heart arteries, to suffer a stroke, or to die than those who received conservative treatment, the researchers found.
The study was to be presented Monday at the American College of Cardiology (ACC) annual meeting in San Diego. Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed medical journal.
"Because people over 80 are underrepresented in clinical trials, they are less likely to receive treatment according to guidelines," study author Dr. Nicolai Tegn, a cardiologist at Rikshospitalet Oslo University Hospital in Norway, said in an ACC news release.
"Our study, which directly targets the over-80 population, is the first to demonstrate that a more invasive strategy results in better outcomes in these patients. I believe our study provides a sufficient basis to recommend an invasive approach," Tegn added.
The American Heart Association has more about acute coronary syndrome.