Coronary revascularization for non-ST elevation acute coronary syndrome: state of the art

Journal of Cardiovascular Medicine
Arno BreemanGiuseppe De Luca

Abstract

Immediate as well as early revascularization may be beneficial in patients with acute coronary syndromes (ACS) without ST elevation, but has traditionally employed as an 'ischemia-guided' strategy. A number of randomized trials (including more than 10 000 patients) and observational studies have compared routine invasive versus selective invasive treatment in patients with an acute coronary syndrome without ST elevation. Most randomized trials are limited by a high cross-over rate, whereas observational studies are limited by selection bias. Data from registries have demonstrated benefits with an invasive approach. The results from randomized trials are less clear regarding mortality reduction, although long-term survival after hospital discharge may be better after the invasive approach. In the randomized trials, there was a decreased risk of death or myocardial infarction after the invasive approach (odds ratio = 0.88, 95% confidence interval = 0.76-1.0). Despite the optimal timing of angiography and subsequent revascularization, if appropriate, angiography and revascularization should be considered in every patient admitted with an ACS without ST elevation, particularly in patients with high-risk characteristics, such as ST ...Continue Reading

References

May 23, 1998·The New England Journal of Medicine·UNKNOWN Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS)
Aug 15, 1998·The New England Journal of Medicine·UNKNOWN Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) Trial Investigato
Dec 14, 1999·Circulation·J T Willerson
Jan 13, 2000·The New England Journal of Medicine·Y YeghiazariansP H Stone
Mar 15, 2000·International Journal of Cardiology·T P ChuaK M Fox
Mar 25, 2000·Journal of the American College of Cardiology·F K Welty
Dec 8, 2000·Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology·M Galli
Jun 23, 2001·The New England Journal of Medicine·C P CannonUNKNOWN TACTICS (Treat Angina with Aggrastat and Determine Cost of Therapy with an Invasive or Conservative Strategy)--Thrombolysis
Jul 14, 2001·Journal of the American College of Cardiology·B LagerqvistUNKNOWN FRISC II Study Group Investigators
Dec 27, 2002·JAMA : the Journal of the American Medical Association·Ruchira GlaserEugene Braunwald
Dec 31, 2002·European Heart Journal·Michel E BertrandUNKNOWN Task Force on the Management of Acute Coronary Syndromes of the European Society of Cardiology
Apr 29, 2003·Age and Ageing·Daniel J BlackmanAdrian P Banning
Apr 24, 2004·Journal of Interventional Cardiology·Peter A McCulloughUNKNOWN TACTICS-TIMI-18 Investigators
Jul 14, 2004·Archives of Internal Medicine·Kristen FranklinUNKNOWN GRACE Investigators
Sep 3, 2004·European Heart Journal·J P OttervangerUNKNOWN GUSTO IV-ACS Investigators
Nov 24, 2004·Scandinavian Cardiovascular Journal : SCJ·Ann-Marie SvenssonMikael Dellborg

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