Use of the early invasive approach in the management of acute coronary syndromes.
Large randomized clinical trials of early invasive versus conservative strategy in patients with non-ST-elevation acute coronary syndromes (NSTE ACS) have been published recently. These studies have clearly shown that intermediate and high-risk patients presenting with NSTE ACS have better outcomes when referred early to cardiac catheterization. Patients who are referred early to cardiac catheterization have a reduction of death, myocardial infarction, and recurrent ischemia, and also have shorter hospital stays. Guidelines recommend referral to cardiac catheterization for intermediate and high-risk NSTE ACS patients within the first 48 hours of presentation. Despite these recommendations, data from a large nationwide registry show that the majority of high-risk patients with NSTE ACS are not being managed with an early invasive strategy.
Saucedo
Jorge F
JF
University of Oklahoma Health Sciences Center, PO Box 26901, Room WP3010, Oklahoma City, OK 73190, USA. jorge-saucedo@ouhsc.edu
Hennebry
Thomas A
TA
D000789:Angina, Unstable / Q000628:therapy*; D006328:Cardiac Catheterization; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D009204:Myocardial Revascularization; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D013577:Syndrome; D015912:Thrombolytic Therapy; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D014443:Tyrosine; D000077466:Tirofiban