Revascularisation or Medical Therapy in Elderly Patients With Acute Anginal Syndromes

Browse trials for

• Acute Coronary Syndrome 1,461
• Syndrome 9,217

Keywords

• Revascularisation, octogenarian,acute coronary syndromes

Acute Coronary Syndrome

1,461 studies on the registry are indexed under Acute Coronary Syndrome; 267 are open to participants now.

This study's enrollment of 250 is above the median of 200 across 869 interventional studies indexed under Acute Coronary Syndrome.

Lead sponsor

Brighton and Sussex University Hospitals NHS Trust is the lead sponsor of 22 studies on the registry; none are open to participants now.

Study arms

• Other
  Conservative Arm- Medical therapy

  Medical therapy

  Drug: Conservative Arm

• Other
  Invasive Arm-angiogram with PCI or CABG

  same medical drug therapy as conservative arm, and angiogram with PCI (percutaneous coronary intervention) or CABG (coronary artery bypass grafting) revascularisation if appropriate

  Procedure: Invasive Arm

Interventions

• DrugConservative Arm

  crossover to angiogram only if predefined criteria met

  Also known as: low molecular weight heparin,, aspirin,, clopidogrel,, beta blocker (Bisoprolol or equivalent), ACE inhibitor (Ramipril or equivalent)

• ProcedureInvasive Arm

  angiogram with PCI or CABG revascularisation if appropriate

Primary outcomes

1. Death

   The cause of death will be adjudicated as being due to cardiovascular causes, non cardiovascular causes, or undetermined causes. * Cardiovascular Death includes sudden cardiac death, death due to acute myocardial infarction, death due to heart failure or cardiogenic shock, death due to stroke or death due to other cardiovascular causes * Non-Cardiovascular Death is defined as any death not covered by cardiac death or vascular death. * Undetermined cause of death refers to a death not attributable to one of the above categories of cardiovascular death or to a non-cardiovascular cause. N.B For this trial all deaths with undetermined causes will be included in the cardiovascular category.

   Time frame: 1 year

2. non-fatal myocardial infarction

   The ESC/ACC (European Society of Cardiology and the American College of Cardiology) definition of myocardial infarction will be applied, including the special circumstances of same admission myocardial re-infarction, or myocardial infarction peri-PCI.

   Time frame: 1 year

Secondary outcomes

1. Unplanned revascularisation

   Shall be deemed to have occurred at follow-up if any coronary vessel requires or undergoes attempted repeat revascularisation with either balloon angioplasty, stenting, or coronary artery bypass grafting.

   Time frame: 1 years

2. Permanent Stroke

   A stroke is a loss of neurological function caused by an ischemic or hemorrhagic event with residual symptoms at least 24 hours after onset or leading to death

   Time frame: 1 year

3. Major bleeding

   BARC (Bleeding Academic Research Consortium) definition

   Time frame: 1 year

4. Deterioration of renal function during hospital admission

   Worsening renal function is an absolute increase in serum creatinine of ≥ 0.3mg/dl (26.5 umol/l) at any time during hospitalization compared to the valve obtained at admission

   Time frame: During index admission

5. Angina symptoms (3 months; 1yr)

   CCS (Canadian Cardiovascular Society Classification of angina) grading of angina

   Time frame: 3 months and 1 year

6. Stent thrombosis

   ARC definition of stent Thrombosis

   Time frame: 1 year

7. All cause mortality

   Cardiac and non cardiac mortality

   Time frame: 2,3 and 4 year

8. Hospital readmission for ACS/STEMI

   ESC/ACC definition ACS/STEMI (Acute coronary syndrome/ST-segment elevation myocardial infarction)

   Time frame: At 3, 6 and 12 months and at 2,3 and 4 years

9. In-hospital major complications

   In hospital major complications defined as death, myocardial infarction, stent thrombosis, target restenosis, repeat target- and non-target vessel-related percutaneous coronary intervention, target lesion revascularization, coronary artery bypass surgery and stroke.

   Time frame: At 3, 6 and 12 months and at 2,3 and 4