In NSTEMI patients with frailty, an initial invasive strategy caused early harm followed by late benefit, resulting in an overall neutral effect on survival at 3 years.
and frailty, an initial invasive strategy caused early harm followed by late benefit, resulting in a neutral effect on survival at 3 years, randomized trial results suggested.The MOSCA-FRAIL trial, conducted at 13 hospitals in Spain, included 167 adults with frailty and NSTEMI, who were randomized to a routine invasive or a conservative strategy.
The main results, reported previously, showed no significant differences in the number of days alive and out of the hospital at 1 year, but worse outcomes were observed among patients who underwent invasive treatment. This secondary analysis looked at whether those findings changed with extended follow-up.After a median follow-up in the total population of 1113 days, there were no differences in the number of days alive between the two groups, with a restricted mean survival time of 3.
However, patients who received invasive treatment tended to have shorter survival in the first year , an effect that gradually neutralized later on, and invasive treatment significantly improved survival time in the landmark analysis after the first year .In patients with frailty and NSTEMI, an initial invasive strategy caused early harm followed by late benefit, resulting in a neutral effect on survival at 3 years.
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