Early invasive vs. selectively invasive management for acute coronoary syndromes

Winter, Robert J.; Windhausen, Fons; Cornel, J.H.; Rice, Cliff

doi:10.1016/j.jemermed.2005.11.032

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Non St-elevation Acute Coronary Syndromes1

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2008

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“…Recent guidelines recommend an early, invasive treatment strategy for patients with high or intermediate risk unstable angina pectoris or Review non ST-segment elevation myocardial infarction [Bassand et al 2007]. These recommendations are based on the results from 3 large, randomized trials (FRISC II (30% women), RITA 3 (38% women), and TACTICS TIMI 18 (35% women)) [Clayton et al 2004;Cannon et al 2001;Lagerqvist et al 2001], while a fourth trial (ICTUS, 26% women) was not able to demonstrate a benefit of a routine, invasive strategy over a selective, ischemia-guided, invasive strategy [de Winter et al 2005].…”

Section: Non St-elevation Acute Coronary Syndromesmentioning

confidence: 99%

Review: Gender differences following percutaneous coronary intervention

Holmvang

Mickley

2008

Therapeutic Advances in Cardiovascular Disease

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PCI is effective for reducing symptoms in patients with stable angina pectoris but does not improve prognosis. In earlier trials PCI has been associated with more procedure related complications in women than men, but this difference between genders has been less pronounced in more recent studies. In acute coronary syndromes there is no evidence of gender differences regarding the benefit of primary PCI for ST-segment elevation myocardial infarction. However, several trials of unstable angina and non-ST-segment elevation myocardial infarction indicate that women do not have the similar benefit of a routine, early, invasive treatment strategy compared with men.

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