After Eighty Study

Conditions

Coronary Heart Disease

Keywords

Coronary heart disease in patients over, 80 years of age.

Brief summary

The rationale of the present clinical trial is to study whether an invasive strategy in clinical stable patients over 80 years with NSTEMI/UAP may improve rates of death, reinfarction, stroke, need of urgent revascularisation, myocardial function and quality of life. The invasive approach involves coronary angiography with immediate evaluation for three different treatment options; 1. Percutaneous coronary intervention (PCI), 2. Coronary artery bypass graft (CABG) or 3. medical treatment. Clinical practice shows that older patients are commonly treated less vigorously than younger patients and the present guidelines are based on a considerably younger population.

Berg ES, Tegn NK, Abdelnoor M, Røysland K, Ryalen PC, Aaberge L, Eek C, Øie E, Juliebø V, Gjertsen E, Ranhoff AH, Gullestad L, Nordstrand N, Bendz B, After Eighty Study Investigators.

2023-11-0115 citations

10.1016/j.jacc.2023.09.809

Patients aged 80 years or older with non-ST-elevation myocardial infarction or unstable angina pectoris randomised to an invasive versus conservative strategy: angiographic and procedural results from the After Eighty study

Nicolai Tegn, Christian Eek, Michael Abdelnoor, Lars Aaberge, Knut Endresen et al. (9 authors)

Open Heart2020-07-019 citations

10.1136/openhrt-2020-001256

Nicolai Tegn, Michael Abdelnoor, Lars Aaberge, Anette Hylen Ranhoff, Knut Endresen et al. (10 authors)

Age and Ageing2017-06-2229 citations

10.1093/ageing/afx121

Invasive versus conservative strategy in patients aged 80 years or older with non-ST-elevation myocardial infarction or unstable angina pectoris (After Eighty study): an open-label randomised controlled trial.

Tegn N, Abdelnoor M, Aaberge L, Endresen K, Smith P, Aakhus S, Gjertsen E, Dahl-Hofseth O, Ranhoff AH, Gullestad L, Bendz B, After Eighty study investigators.

2016-01-13301 citations

10.1016/s0140-6736(15)01166-6

Interventions

None listed

Study design

Observational model

CASE_CONTROL

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

80 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* Age ≥ 80 years. * Acute coronary syndrome (NSTEMI/UAP) with chest pain \> 10 minutes, with or without ST-segment depression in ECG, and normal or elevated levels of troponin T or I. Elevated troponin levels are defined as values exceeding the 99 percentile of a normal population at the local laboratory at each participating site. * Clinical stable

Exclusion criteria

* Age \< 80 years. * ST-segment elevation in ECG (STEMI) * Clinical unstable with ongoing chest pain or other ischaemic symptoms/signs. * Cardiogenic shock. * Short life expectancy due to extra cardiac reason, ie. COPD, disseminated malignant disease, or other reason. * Anamnestic indications for significant mental disorder, including dementia. * Any condition which interferes with patients possibility to comply with protocol.

Design outcomes

Primary

Measure	Time frame	Description
Composite endpoints.	One year follow up.	Does an invasive strategy in clinical stable patients over 80 years with NSTEMI/UAP improve rates of death, reinfarction, stroke and need of urgent revascularisation?

Secondary

Measure	Time frame
Death of any cause	One year from randomization

Countries

Norway

Outcome results