TY - JOUR
T1 - Should the emergence of new agents change the management of patients with acute coronary syndromes without ST-segment elevation?
AU - Califf, R. M.
AU - Holmes, Jr
PY - 1999
Y1 - 1999
N2 - Cardiac catheterization for diagnostic angiography and revascularization, if indicated, plays an increasing role in the management of acute coronary syndromes in the absence of ST elevation. The disagreement between those who favor a conservative approach to intervention and those who favor an aggressive approach centers on whether interventions should be routinely performed in all patients. New pharmacotherapies have emerged that reduce the incidence of death and myocardial infarction in this group of patients. At the same time, the success rate of percutaneous revascularizations has been improved by the widespread use of stenting, and a reduction in complications has been achieved with new pharmacologic agents. As therapies are rapidly evolving, it is difficult to extrapolate the results of earlier clinical trials to the most current practices. Until evidence is available comparing optimal medical management with the most successful interventional techniques, the best approach to intervention is likely to remain the subject of discussion.
AB - Cardiac catheterization for diagnostic angiography and revascularization, if indicated, plays an increasing role in the management of acute coronary syndromes in the absence of ST elevation. The disagreement between those who favor a conservative approach to intervention and those who favor an aggressive approach centers on whether interventions should be routinely performed in all patients. New pharmacotherapies have emerged that reduce the incidence of death and myocardial infarction in this group of patients. At the same time, the success rate of percutaneous revascularizations has been improved by the widespread use of stenting, and a reduction in complications has been achieved with new pharmacologic agents. As therapies are rapidly evolving, it is difficult to extrapolate the results of earlier clinical trials to the most current practices. Until evidence is available comparing optimal medical management with the most successful interventional techniques, the best approach to intervention is likely to remain the subject of discussion.
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U2 - 10.1053/hj.1999.v138.a102300
DO - 10.1053/hj.1999.v138.a102300
M3 - Article
C2 - 10577466
AN - SCOPUS:0032732543
SN - 0002-8703
VL - 138
SP - S586-S594
JO - American heart journal
JF - American heart journal
IS - 6 II
ER -