Trial reportEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2021
Revascularisation or medical therapy in elderly patients with acute anginal syndromes: the RINCAL randomised trial.
Trial report in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 7 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Invasive Versus Conservative Management Among Older Adult Patients With Non-ST-Segment-Elevation Myocardial Infarction: A Meta-Analysis of Randomized Controlled Trials.Journal of the American Heart Association · 2025Pooled it
- Invasive Strategy With Intended Percutaneous Coronary Intervention Versus Conservative Treatment in Older People With ST-Segment-Elevation Myocardial Infarction: A Meta-Analysis.Journal of the American Heart Association · 2025Pooled it
- Invasive versus conservative strategies for non-ST-elevation acute coronary syndrome in the elderly: an updated systematic review and meta-analysis of randomized controlled trials.BMC cardiovascular disorders · 2025Pooled it
- Invasive treatment strategy for older patients with non-ST-elevation acute coronary syndrome: a systematic review and meta-analysis of randomized controlled trials.Frontiers in cardiovascular medicine · 2025Pooled it
- Invasive Versus Conservative Strategy in Older Adults ≥75 Years of Age With Non-ST-segment-Elevation Acute Coronary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of the American Heart Association · 2024Pooled it
- Non-ST-elevation acute coronary syndromes with previous coronary artery bypass grafting: a meta-analysis of invasive vs. conservative management.European heart journal · 2024Pooled it
- Invasive vs. conservative management of older patients with non-ST-elevation acute coronary syndrome: individual patient data meta-analysis.European heart journal · 2024Pooled it
- Early invasive approach and outcome in elderly patients with NSTEACS: randomised trials, real-world data and guideline recommendations.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2021Trial
- Invasive versus medically managed acute coronary syndromes with prior bypass (CABG-ACS): insights into the registry versus randomised trial populations.Open heart · 2021Trial
- Long-Term Clinical Outcomes of PCI Versus Medical Therapy in NSTEMI Patients with Prior CABG.Medicina (Kaunas, Lithuania) · 2026Article
- Coronary Artery Revascularization in the Older Adult Population: A Scientific Statement From the American Heart Association.Circulation · 2025Review
- Acute Coronary Syndrome Management in Older Patients: A Dual-Center Retrospective Cohort Study.Medicina (Kaunas, Lithuania) · 2025Article
- Treatment of non-ST-segment elevation myocardial infarction in the elderly: the SENIOR-RITA trial.European heart journal supplements : journal of the European Society of Cardiology · 2025Article
- Percutaneous coronary intervention in elderly patients: clinical benefits and challenges from single center experience.American journal of cardiovascular disease · 2025Article
- Older women with non-ST-elevation acute coronary syndrome undergoing invasive or conservative management: an individual patient data meta-analysis.European heart journal open · 2024Article
- Routine invasive strategy and frailty burden in non-ST-segment elevation acute myocardial infarction.Journal of geriatric cardiology : JGC · 2024Article
- Management of Acute Coronary Syndrome in Elderly Patients: A Narrative Review through Decisional Crossroads.Journal of clinical medicine · 2024Review
- Acute Coronary Syndrome in Elderly Patients: How to Tackle Them?Journal of clinical medicine · 2024Review
- Current Management of Non-ST-Segment Elevation Acute Coronary Syndrome.Biomedicines · 2024Review
- Early Invasive Strategy for Octogenarians and Nonagenarians With Acute Myocardial Infarction.Circulation reports · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 11 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHistorically the elderly have been under-represented in non-ST-elevation myocardial infarction (NSTEMI) management trials.
aimsThe aim of this trial was to demonstrate that an intervention-guided strategy is superior to optimal medical therapy (OMT) alone for treating NSTEMI in elderly individuals.
methodsPatients (≥80 years, chest pain, ischaemic ECG, and elevated troponin) were randomised 1:1 to an intervention-guided strategy plus OMT versus OMT alone. The primary endpoint was a composite of all-cause mortality and non-fatal myocardial reinfarction at 1 year. Ethics approval was obtained by the institutional review board of every recruiting centre.
resultsFrom May 2014 to September 2018, 251 patients (n=125 invasive vs n=126 conservative) were enrolled. Almost 50% of participants were female. The trial was terminated prematurely due to slow recruitment. A Kaplan-Meier estimate of event-free survival revealed no difference in the primary endpoint at 1 year (invasive 18.5% [23/124] vs conservative 22.2% [28/126]; p=0.39). No significant difference persisted after Cox proportional hazards regression analysis (hazard ratio 0.79, 95% confidence interval 0.45-1.35; p=0.39). There was greater freedom from angina at 3 months (p<0.001) after early intervention but this was similar at 1 year. Both non-fatal reinfarction (invasive 9.7% [12/124] vs conservative 14.3% [18/126]; p=0.22) and unplanned revascularisation (invasive 1.6% [2/124] vs conservative 6.4% [8/126]; p=0.10) occurred more frequently in the OMT alone cohort.
conclusionsAn intervention-guided strategy was not superior to OMT alone to treat very elderly NSTEMI patients. The trial was underpowered to demonstrate this definitively. Early intervention resulted in fewer cases of reinfarction and unplanned revascularisation but did not improve survival.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.