ESC Congress 2024 — No difference in cardiovascular outcomes between invasive and conservative strategies in elderly NSTEMI patients. 

Principal Investigator, Prof Vijay Kunadian (Newcastle upon Tyne Hospitals NHS Trust, UK) join us in London to discuss the key findings from the SENIOR RITA trial (NCT03052036; Newcastle-upon-Tyne Hospitals NHS Trust).

The SENIOR-RITA trial is a multicenter, open-label study enrolling 1518 patients aged 75 years or older who experienced a type 1 NSTEMI. Participants were randomly assigned to either an invasive or conservative treatment strategy. The conservative arm received standard guideline-directed medical therapy, including antiplatelet agents, statins, ACE inhibitors, and beta-blockers. The invasive group underwent coronary angiography with potential subsequent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The primary outcome is the time to cardiovascular death or non-fatal myocardial infarction, defined by the fourth universal definition, from randomization up to five years.

Findings showed no significant difference between an invasive and conservative treatment strategy in older patients in terms of a composite outcome of CV mortality or MI, however, patients in the invasive group had significantly lower urgent revascularisation rates when compared to the conservative treatment group.

Interview Questions:

1. What is the background of the SENIOR RITA trial?
2. What was the study design, eligibility criteria and outcome measures? (+Why 75 and over?)
3. What are the baseline characteristics of the randomised patients?
4. What are the key findings?
5. Were there any unexpected or surprising findings?
6. What are the take-home messages?

Recorded on-site at ESC Congress 2024, London.

Editors: Jordan Rance and Mirjam Boros.
Videographers: Mike Knight, Dan Brent, Oliver Miles, Tom Green, David-Ben-Harosh.

Support: This is an independent interview produced by Radcliffe Cardiology.