Routine vs selective invasive strategies in patients with acute coronary syndromes: a collaborative meta-analysis of randomized trials

Citation

(2006), "Routine vs selective invasive strategies in patients with acute coronary syndromes: a collaborative meta-analysis of randomized trials", Clinical Governance: An International Journal, Vol. 11 No. 4. https://doi.org/10.1108/cgij.2006.24811dae.006

Routine vs selective invasive strategies in patients with acute coronary syndromes: a collaborative meta-analysis of randomized trials

S.R., Mehta, C.P. Cannon, K.A. Fox, L. Wallentin, W.E. Boden, R. Spacek, P. Widimsky, P.A. McCullough, D. Hunt, E. Braunwald, S. YusufJournal of the American Medical Association2005Vol. 293 No. 23pp. 2908-2917

This review compared routine versus selective invasive strategies for unstable angina and non-ST-segment elevation myocardial infarction. A routine invasive strategy was defined as the referral of all patients with unstable angina or NSTEMI for coronary angiography, followed by revascularisation in those with suitable coronary anatomy. A selective invasive strategy was defined as an approach in which patients were initially treated with pharmacological therapy, after which cardiac catheterisation and revascularisation were performed only for those with recurrent symptoms or objective evidence of inducible ischaemia on noninvasive testing. The authors concluded that the routine invasive strategy reduced long-term myocardial infarction, angina and rehospitalisation. Incomplete reporting of the review methods and the lack of a validity assessment make it difficult to comment on the strength of the evidence for the authors’ conclusions.