title: [The effect of early invasive strategy on early and late outcomes in high-risk non-ST-segment elevation acute coronary syndromes].
abstract: OBJECTIVE
  To investigate the effect of early invasive strategy on early and late outcomes in high-risk patients with non-ST-segment elevation acute coronary syndromes (ACS).
  
  
  METHODS
  Five hundred and forty-five patients of ACS without ST-segment elevation were randomly assigned to an early conservative strategy (284 cases) or early invasive strategy group (261 cases), who were enrolled consecutively from Oct., 2001 to Oct., 2003. The combined cardiovascular events (a combination of cardiac death, nonfatal myocardial infarction, nonfatal heart failure and hospital readmission due to recurrent ischemic angina) within 30 days and 6 months were analyzed and the effects of early invasive strategy on early and late outcomes in high-risk patients with increased TnI or hs-CRP levels were evaluated.
  
  
  RESULTS
  As compared with early conservative strategy, early invasive strategy lowered the rate of hospital readmission due to recurrent ischemic angina of 30 d and the combined cardiovascular events of 30 d and 6 months (all P < 0.05). Subgroup analysis indicated early invasive strategy could significantly decrease the incidences of the combined cardiovascular events of 30 d and 6 months and the hard end point events of 6 months in patients with increased TnI or hs-CRP levels (all P < 0.01), but no such changes could be seen in patients with normal TnI or hs-CRP levels, as compared with early conservative strategy.
  
  
  CONCLUSIONS
  Early invasive strategy decreases significantly cardiovascular events and improves the early and late outcomes in high-risk patients with increased TnI or hs-CRP levels.
authors.affiliation: Department of Cardiology, People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Ming-zhong
authors.initials: MZ
authors.lastname: Zhao
authors.forename: Da-yi
authors.initials: DY
authors.lastname: Hu
authors.forename: Li-qing
authors.initials: LQ
authors.lastname: Jiang
authors.forename: Yang
authors.initials: Y
authors.lastname: Wu
authors.forename: Tian-gang
authors.initials: TG
authors.lastname: Zhu
authors.forename: Heng-jian
authors.initials: HJ
authors.lastname: Hao
authors.forename: Li-jing
authors.initials: LJ
authors.lastname: Zhang
authors.forename: Yong
authors.initials: Y
authors.lastname: Huo
authors.forename: Ming-sheng
authors.initials: MS
authors.lastname: Wang
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000628:therapy*; D002097:C-Reactive Protein / Q000032:analysis; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D011379:Prognosis; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood
chemical_list: D019210:Troponin I; D002097:C-Reactive Protein