Association of revascularisation with low mortality in non-ST elevation acute coronary syndrome, a report from GUSTO IV-ACS

European Heart Journal
Jan Paul OttervangerGUSTO IV-ACS Investigators

Abstract

Immediate, as well as early, revascularisation is of benefit in patients with acute coronary syndromes (ACS) presenting with ST elevation. However, trials comparing invasive versus medical treatment in patients with an acute coronary syndrome without ST elevation do not consistently show improvement in survival after revascularisation. Accordingly, additional data are warranted. The effect of revascularisation within 30 days on one-year survival in the GUSTO IV ACS trial was investigated. A total of 7800 patients were included with an acute coronary syndrome without ST elevation, documented by either elevated cardiac troponin or transient or persistent ST-segment depression. In this trial, comparing abciximab versus placebo as initial medical therapy, coronary angiography within 60 h after randomisation was discouraged. In 30-day survivors, those who underwent revascularisation were compared with 30-day survivors without revascularisation. Adjustments were made for patient characteristics, and for a propensity score that was adjusted for covariates associated with the likelihood of early revascularisation. Of the 7496 patients who survived at least 30 days, 2265 (30%) underwent coronary revascularisation within 30 days: 789 pat...Continue Reading

Citations

Nov 23, 2013·The American Journal of Medicine·Dhaval KolteWilbert S Aronow
Jul 15, 2006·International Journal of Cardiology·David HarpazUNKNOWN Israeli Working Group on Intensive Cardiac Care, Israel Heart Society
Jan 28, 2010·American Heart Journal·Esam ElbarasiUNKNOWN Canadian Global Registry of Acute Coronary Events (GRACE/expanded-GRACE) Investigators
Apr 29, 2006·Journal of Cardiovascular Medicine·Arno BreemanGiuseppe De Luca
Aug 15, 2006·Coronary Artery Disease·Elisabeth PerersMarianne Hartford
Mar 17, 2005·European Heart Journal·Sigmund SilberUNKNOWN Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology

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