Use of the early invasive approach in the management of acute coronary syndromes
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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.
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- Braunwald E, Antman EM, Beasley JW, et al.: ACC/AHA guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction-2002: summary article. Circulation 2002, 106:1893-1900. This is the updated guideline summary document for the management of patients with NSTE ACS. It provides the current clinical recommendations not only regarding the early invasive approach but also general therapies that have been shown to be useful or are contraindicated in patients with NSTE ACS.
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- Use of the early invasive approach in the management of acute coronary syndromes
Current Cardiology Reports
Volume 6, Issue 4 , pp 287-291
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