April 29, 2021

Background: Non-ST-elevation myocardial infarction (NSTEMI) is defined as acute coronary injury resulting in ischemia and myocardial infarction. The diagnosis is made based on clinical presentation and non-specific electrocardiogram (ECG) changes including ST-segment depression, T-wave inversions, or other nonspecific findings.1 Based on data from the NHS, most patients with NSTEMI are 70 years or older.2 This, coupled with an increasing aging population, raises the question, what is the best management in patients 80 years old or older with NSTEMI?

Previous studies have attempted to evaluate the best approach to elderly patients with NSTEMI, but the mean age of patients was 66 years old with few patients over 80 years old leaving few data to extrapolate these results to this specific population age.3 The best means of obtaining data to answer clinical questions is through prospective randomized trials and there is an upcoming trial to answer this question specifically, the SENIOR-RITA (cool name) will not be expected to complete enrolment prior to 2029. In the meantime, this trial (SENIOR-NSTEMI) was conducted to provide further data regarding the best management of patients older than 80 years old with a NSTEMI.