EVAOLD trial provides guidance on treating older patients after a heart attack
A routine invasive approach should not be replaced with a more selective approach in older patients with the most common type of heart attack. This was the main finding of the EVAOLD trial presented in a Hot Line session today at ESC Congress 2026.
The EVAOLD trial, presented at ESC Congress 2026, provides guidance on treating older patients after a heart attack, specifically those with non-ST-segment elevation myocardial infarction (NSTEMI), the most common type of heart attack. The main finding suggests that a routine invasive approach should not be replaced with a more selective approach in older patients.
The trial compared stress imaging-guided selective invasive management with routine invasive management, finding that while the selective strategy reduced the need for coronary angiography and related complications, it did not demonstrate noninferiority to routine invasive management for major cardiovascular events in patients aged 80 and older.
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