Revascularization not superior to conservative treatment of acute coronary syndromes.
Conservative treatment was nearly as effective as immediate catheterization and surgical intervention in patients presenting with acute coronary syndrome. No difference was noted in the risk of death or myocardial infarction in either group. Patients were less likely to experience refractory angina when evaluated at 4 months and after 1 year when treated aggressively (numbers needed to treat [NNT]=20). Saving 1 readmission for refractory angina at the cost of performing 19 interventions that have no effect on the patient may not be reasonable.
Phillips
T Grant
TG
Washington Hospital Family Practice Residency, Pennsylvania, USA. tphillips@washingtonhospital.org