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January 1, 2002European Heart JournalOpen Access

ST depression in ECG at entry indicates severe coronary lesions and large benefits of an early invasive treatment strategy in unstable coronary artery disease. The FRISC II ECG substudy

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Key result

An early invasive strategy reduced mortality from 5.8% to 3.3% (P=0.050) in patients with unstable coronary artery disease and ST-segment depression.

Why the study?

Does an early invasive strategy reduce death or myocardial infarction in patients with unstable coronary artery disease stratified by ST-segment depression?

Population

2457 patients with unstable coronary artery disease

Comparison

Early invasive strategy with coronary… vs Non-invasive strategy with coronary procedures…

Design

RCT, randomized

Authors

EDErik DiderholmVästerås Municipality

Discussion

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Implication

Supports early invasive strategy in unstable CAD with ST depression; extends randomized evidence for risk-stratified revascularization.

Study Design

Type

RCT (n=2,457)

Randomization

randomized

Structured PICO

Does an early invasive strategy reduce death or myocardial infarction in patients with unstable coronary artery disease stratified by ST-segment depression?

P
Population
2457 patients with unstable coronary artery disease
I
Intervention
Early invasive strategy with coronary angiography/revascularization within 7 days
C
Comparator
Non-invasive strategy with coronary procedures only when symptoms or severe ischaemia recurred
O
Outcome
Death or myocardial infarctionhard clinical

Main Result

Absolute Event Rate: 3.3% vs 5.8%

p-value: p=0.050

In patients with unstable coronary artery disease, ST-segment depression identifies a high-risk group with more severe coronary lesions who derive significant mortality and morbidity benefits from an early invasive strategy.

Cite This Study

Erik Diderholm (2002) conducted an RCT in Unstable coronary artery disease (n=2,457). Early invasive strategy (coronary angiography/revascularization within 7 days) vs. Non-invasive strategy was evaluated on Mortality in patients with ST-segment depression (p=0.050). An early invasive strategy reduced mortality from 5.8% to 3.3% (P=0.050) in patients with unstable coronary artery disease and ST-segment depression.

synapsesocial.com/papers/6a051222fba2ba61ab55fc5fhttps://doi.org/10.1053/euhj.2001.2694

Topics

Coronary artery disease
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Risk stratification of patients with non-Q wave myocardial infarction. The critical role of ST segment depression. The Diltiazem Reinfarction Study Research Group.1989 · 93 citations
  2. 2Prognostic Value of the Admission Electrocardiogram in Acute Coronary Syndromes1999 · 563 citations
  3. 3Early continuous ST segment monitoring in unstable angina: prognostic value additional to the clinical characteristics and the admission electrocardiogram.1996 · 92 citations
  4. 4Very early risk stratification by electrocardiogram at rest in men with suspected unstable coronary heart disease1993 · 150 citations
  5. 5A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association1975 · 3,260 citations