Invasive versus conservative strategies for non-ST-elevation acute coronary syndrome in the elderly: an updated systematic review and meta-analysis of randomized controlled trials.

In contrast to the neutral effect in the overall population, stroke risk trended higher with the invasive strategy in octogenarians (RR: 1.20, 95% CI: 0.85–1.90), though this difference did not reach statistical significance (Figure S1D).

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Similarly, the analysis of major bleeding in this subgroup showed a nonsignificant trend toward increased risk (RR: 1.92, 95% CI: 0.01–470.93), though with substantial uncertainty in the estimate.

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This vulnerability to stroke complications in the most elderly patients was further supported by our meta-regression analysis, which demonstrated a positive trend corresponding to a 15% increase in stroke relative risk for each year of advancing age.

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