coronary disease, acute coronary syndrome, without ST-segment elevation
DISEASE INTERVENTION COMPARISON RESULTS
Lancet. 2006 Sep 16;368(9540):998-1004 Randomized Controlled Trial, Multicenter Study
IN coronary disease, acute coronary syndrome, without ST-segment elevation The Use of
early invasive strategy with coronary angiography and, if appropriate, revascularisation within 7 days
As Treatment, Acute
Is better Than
conservative strategy: non-invasive primarily medical strategy
To reduce at 5 years death or myocardial infarction: 19.9% invasive strategy VS 24.5% conservative strategy.
Ann Intern Med. 2008 Feb 5;148(3):186-96 Systematic Review
IN coronary disease, acute coronary syndrome, without ST-segment elevation The Use of
routine invasive strategy (angiography and revascularization)
As Treatment, Acute
Is equal Than
conservative strategy (ischaemia- or symptom-driven angiography)
To reduce mortality (RR 0.90, 0.80 to 1.14) or re-infarction (RR 0.86, 0.68 to 1.08)
Eur Heart J. 2012 Jan;33(1):51-60 Randomized Controlled Trial
IN coronary disease, acute coronary syndrome, without ST-segment elevation, women The Use of
routine invasive strategy (angiography and revascularization)
As Treatment, Acute
Is worse Than
conservative strategy (ischaemia- or symptom-driven angiography)
To routine invasive strategy increased death at 1 year in women (8.8% VS 1.1% in the RCT and OR 1.51 in the meta-analysis) and did NOT modify MI and stroke rates. Results in men are not always extapolable to women