{"title":"Early invasive strategy should be performed within 72 hours in high-risk patients with non-ST-elevation myocardial infarction.","authors":"Carlos Collet, Patrick W Serruys","doi":"10.1136/ebmed-2017-110848","DOIUrl":null,"url":null,"abstract":"Commentary on : Jobs A, Mehta SR, Montalescot G, et al . Optimal timing of an invasive strategy in patients with non-ST-elevation acute coronary syndrome: a meta-analysis of randomised trials. Lancet 2017;390:737–46.\n\nThe mainstay of treatment for patients presenting with non-ST-elevation acute coronary syndrome (NSTE-ACS) is medical therapy, early coronary angiography and revascularisation. A routine invasive strategy has been shown to reduce all-cause death and myocardial infarction compared with a conservative approach at 5 years.1 Therefore, an early invasive strategy with intent to perform revascularisation is advocated in the 2014 American and European guidelines with a class I recommendation.2 3 While immediate angiography is recommended for extremely high-risk patients (eg, haemodynamic or electrical instability, persistent angina, heart failure or worsening mitral regurgitation), the optimal timing for an invasive approach in patients …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":" ","pages":"227"},"PeriodicalIF":0.0000,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110848","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Evidence-Based Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/ebmed-2017-110848","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2017/11/23 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
Abstract
Commentary on : Jobs A, Mehta SR, Montalescot G, et al . Optimal timing of an invasive strategy in patients with non-ST-elevation acute coronary syndrome: a meta-analysis of randomised trials. Lancet 2017;390:737–46.
The mainstay of treatment for patients presenting with non-ST-elevation acute coronary syndrome (NSTE-ACS) is medical therapy, early coronary angiography and revascularisation. A routine invasive strategy has been shown to reduce all-cause death and myocardial infarction compared with a conservative approach at 5 years.1 Therefore, an early invasive strategy with intent to perform revascularisation is advocated in the 2014 American and European guidelines with a class I recommendation.2 3 While immediate angiography is recommended for extremely high-risk patients (eg, haemodynamic or electrical instability, persistent angina, heart failure or worsening mitral regurgitation), the optimal timing for an invasive approach in patients …