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[Correspondence] Invasive strategy in acute coronary syndrome

Contemporary guidelines recommend an invasive strategy in patients with non-S-elevation myocardial infarction or unstable angina. Any uncertainty about the relevance of this recommendation to patients aged 80 years or older—who are under-represented in previous trials—should now be dispelled by the findings of the After Eighty study (March 12, p 1057),1 which showed a significant reduction in the primary outcome in the group randomised to early coronary angiography. However, 35% of the 4187 patients assessed for eligibility for the trial were excluded because of short life expectancy or dementia.