RINCAL Trial
Research type
Research Study
Full title
Revascularisation or medical therapy in elderly patients with acute anginal syndromes.
IRAS ID
124313
Contact name
Adam de Belder
Contact email
Sponsor organisation
Brighton and Sussex University Hospitals NHS Trust
Research summary
Despite the enormous amount of published information around acute coronary syndromes (ACS), there is only a very small amount of data on the management of ACS in the elderly, octogenarian population. Approximately 33% of all ACS episodes in the UK occur in patients over 75 years. The incidence of ACS in the octogenarian is projected to increase due to advances in ACS treatment in an aging population.
Treatment for non-ST elevation myocardial infarction (NSTEMI) can be divided into two groups Optimal Medical Therapy (OMT)or Optimal Medical Therapy plus revascularisation. Optimal Medical Therapy (conservative arm)consists of heparin, aspirin, clopidogrel, beta blocker and a statin in the acute situation followed by a plan to optimise long term medical treatment in order to reduce future cardiac events. Optimal Medical Therapy plus Revascularisation (invasive arm) refers OTM together with coronary angiogram followed by either stent insertion or coronary atery bypass graft surgery (CABG).
As yet, no large randomised controlled trial (RCT) comparing OMT and OMP plus revascularisation has been undertaken in octogenarian patients. The small amount of data that is available appears to demonstrate a greater benefit from revascularisation, yet it is common for this to be denied to them.
Our aim is to recruit over 700 patients 80 years or over to a randomised controlled trial comparing revascularisation plus OMT(invasive arm)versus optimal medical therapy (conservative arm). Research has been undertaken in younger patients the gap in knowledge is in patients aged 80 or over.
REC name
London - Brighton & Sussex Research Ethics Committee
REC reference
13/LO/1082
Date of REC Opinion
27 Nov 2013
REC opinion
Further Information Favourable Opinion