Evidence map›Paper›PMID 41637115›Full record

SynthesisFuture cardiology2026

Invasive versus conservative strategy in older adults ≥70 years of age with non-ST-segment-elevation myocardial infarction: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials with trial sequential analysis.

Ubaid Khan, Junaid Ali, Muhammad Haris Khan, Mahmoud Shaaban Abdelgalil, Zuhair Majeed, Muhammad Abdullah Naveed, Ahmed Mazen Amin, Anum Nawaz, Mohamed Abuelazm, Mustafa Turkmani and 3 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Future cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Ubaid KhanDivision of Cardiology, University of Maryland School of Medicine, Baltimore, MD, USA.ORCID 0000-0003-3216-6323
Junaid AliDepartment of Medicine, Saint Peter's University Hospital, New Brunswick, NJ, USA.
Muhammad Haris KhanDepartment of Medicine, Saidu Medical College, Swat, Pakistan.ORCID 0009-0000-3250-2601
Mahmoud Shaaban AbdelgalilFaculty of Medicine, Ain Shams University, Cairo, Egypt.
Zuhair MajeedDepartment of Medicine, King Edward Medical University, Lahore, Pakistan.ORCID 0009-0003-7674-4436
Muhammad Abdullah NaveedDepartment of Medicine, Dow Medical University, Karachi, Pakistan.
Ahmed Mazen AminFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Anum NawazDepartment of Radiology, Pakistan Atomic Energy Commission Hospital, Islamabad, Pakistan.
Mohamed AbuelazmFaculty of Medicine, Tanta University, Tanta, Egypt.
Mustafa TurkmaniDivision of Pulmonary and Critical Care, University of Toledo, Toledo, OH, USA.
Muhammad AamirDepartment of Cardiology, Lehigh Valley Heart and Vascular Institute, Allentown, PA, USA.
Apurva V VyasDepartment of Cardiology, Lehigh Valley Heart and Vascular Institute, Allentown, PA, USA.
Sourbha DaniDepartment of Cardiology, Lahey Hospital & Medical Center, Burlington, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOlder adults with Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) are often undertreated invasively due to concerns about risks and comorbidities, despite potential benefits. Their limited inclusion in clinical trials leaves a gap in evidence-based management. This meta-analysis compared invasive versus conservative strategies in elderly NSTEMI patients.

methodsA systematic search was conducted across PubMed, CENTRAL, Web of Science, Scopus, and Embase through December 2024. Pooled results were reported using risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes with 95% confidence intervals (CI).

resultsA total of 11 randomized controlled trials involving 4114 patients were included. Invasive treatment significantly reduced the composite of all-cause mortality and non-fatal MI (RR: 0.82; 95% CI: 0.68-0.99;

conclusionIn NSTEMI patients aged ≥70, invasive management reduces the risk of MI and revascularization without increasing mortality risk. More elderly-focused trials are warranted. PROTOCOL REGISTRATION: https://www.crd.york.ac.uk/prospero identifier is CRD42025633157.

Indexed as

Conservative TreatmentMyocardial RevascularizationNon-ST Elevated Myocardial InfarctionPercutaneous Coronary InterventionAgedHumansRandomized Controlled Trials as Topicall-cause mortalityCABGelderly populationNSTEMIPCI

Identifiers

PMID41637115
PMCPMC13020887

What OpenQuestion holds

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Registered trials

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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.