title: Routine invasive versus conservative management in non-ST-elevation acute coronary syndromes.
abstract: Coronary angiography as part of the management of non-ST-segment-elevation acute coronary syndrome (ACS) patients has several advantages but also carries some risks if done routinely. The advantage of a planned early invasive approach in moderate to high-risk patients appears to be clear and is recommended by guidelines. This is often not mirrored by real world practice; however, only about 50% to 70% of ACS patients do undergo a diagnostic catheterization. In addition, the optimal timing of an angiography or intervention in relation to contemporary antithrombotic regimens remains unclear. In this paper, the current evidence for routine invasive management as well as the timing of catheterization in non-ST-ACS is reviewed.
authors: Division of Cardiovascular Diseases, University Hospitals Leuven-Campus Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium. peter.sinnaeve@uzleuven.be
authors: Peter R
authors: PR
authors: Sinnaeve
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000401:mortality; D017023:Coronary Angiography; D019317:Evidence-Based Medicine; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents