Early-invasive or early-conservative management of patients with unstable angina or non-Q-wave myocardial infarction.
The optimal therapy for non-ST-segment-elevation acute coronary syndromes is the subject of considerable debate: is early catheterization and revascularization (early-invasive strategy) or continued medical therapy unless symptoms are refractory (early-conservative strategy) best? Although several clinical trials have sought to answer this question, the methodologies they employed have been widely criticized, and no consensus has been reached. The new antiplatelet therapies have proved beneficial for primary medical management and as adjuncts to percutaneous interventions. It is not yet clear, however, whether use of these therapies will preferentially benefit one of the treatment strategies.
Scripps Memorial Hospital, Division of Cardiology, LaJolla, California 92037, USA.
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Goodman
D000465:Algorithms; D000789:Angina, Unstable / Q000628:therapy*; D006328:Cardiac Catheterization; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D009204:Myocardial Revascularization; D015912:Thrombolytic Therapy; D016896:Treatment Outcome