SynthesisJournal of the American Heart Association2025
Invasive Strategy With Intended Percutaneous Coronary Intervention Versus Conservative Treatment in Older People With ST-Segment-Elevation Myocardial Infarction: A Meta-Analysis.
Synthesis in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis 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
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Guideline for the Comprehensive Perioperative Management of Older Patients With Lung Cancer (2025).Journal of evidence-based medicine · 2026Guideline
- Percutaneous Coronary Interventions in Nonagenarians: Single-Centre Insights.Journal of clinical medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients ≥80 years old were underrepresented or excluded from landmark trials demonstrating the superiority of primary percutaneous coronary intervention (PCI) in ST-segment-elevation myocardial infarction. The current meta-analysis assessed the effects of an invasive strategy with intended PCI compared with conservative treatment in older people (≥80 years) with ST-segment-elevation myocardial infarction.
methodsA structured literature search was performed. The primary outcome was overall survival. Secondary outcome analyses included but were not limited to 30-day and 1-year mortality.
resultsThirteen studies reporting on 102 158 older adults were included. Of these, 31 629 (31%) were assigned to PCI and 70 529 (69%) were treated conservatively. The overall survival was 76.5% in PCI and 67.2% in conservative treatment at the time of longest available follow-up (odds ratio [OR], 2.18 [95% CI, 1.79-2.66],
conclusionsThis meta-analysis indicates a potential underuse of PCI in older adults with ST-segment-elevation myocardial infarction. PCI was advantageous in short- and long-term survival, but these results were affected by confounding. Nonetheless, every second patient not referred for invasive treatment survived at least 1 year. These findings have hypothesis generating implications, but they indicate ageism and emphasize that PCI should not be automatically withheld in older patients.
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Registered trials
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.