Public Defence: Nicolai Kloumann Tegn
Cand.med. Nicolai Kloumann Tegn at Institute of Clinical Medicine will be defending the thesis “Invasive versus conservative strategy in the very elderly with acute coronary syndrome” for the degree of PhD (Philosophiae Doctor).
Trial Lecture – time and place
See Trial Lecture.
- First opponent: Senior Consultant Leif Thuesen, Aalborg University Hospital, Denmark
- Second opponent: Senior Consultant Terje K. Steigen, University Hospital of North Norway
- Third member and chair of the evaluation committee: Associate Professor Kirsten Krogh-Sørensen, University of Oslo
Chair of the Defence
Professor II Johny Kongerud, Faculty of Medicine, University of Oslo
Associate Professor Bjørn Bendz, Faculty of Medicine, University of Oslo
The very elderly (>80 years of age) constitute a rapidly increasing subgroup of patients presenting with ischemic heart disease. They tend to have more advanced comorbidity than younger patients and are more often characterized by frailty, including physical functional decline, decreased nutritional intake, and reduced cognitive and physical resistance to stressors. It is a heterogenous group, sometimes with a chronological-biological age mismatch, and tailored treatment is more important than in younger patients.
The After Eighty study is the first RCT specifically targeting very elderly patients with NSTEMI or UAP. The findings in the After Eighty study, supports the invasive strategy with a reduction of composite endpoints (MI, need for urgent revascularization, stroke, and death) and confirms that invasive management of NSTEMI or UAP can be performed in clinically stable octogenarians without compromising patient safety. However, a dilution of the efficacy occurred with increasing age, and for patients > 90 years of age we cannot conclude whether an invasive strategy is beneficial.
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