Key result
Early use of primary PCI compared to conservative management shows inconsistent findings overall, but strong evidence supports its early use in moderate to high-risk NSTEMI patients.
Why the study?
Does an early invasive strategy (routine primary PCI) improve clinical outcomes compared to conservative management in patients with NSTEMI?
Does an early invasive strategy (routine primary PCI) improve clinical outcomes compared to conservative management in patients with NSTEMI?
Current evidence favors conservative management in low-risk NSTEMI patients and early invasive management (PCI) for moderate to high-risk NSTEMI patients.
Supports selective early PCI in moderate- to high-risk NSTEMI; leaves open optimal timing for low-risk patients pending higher-level trials.
Non ST elevated myocardial infarction (NSTEMI) accounts for a significant portion of the hospitalizations due to acute coronary syndromes worldwide and is posing a huge challenge towards the health care cost globally. This signifies the need for proper triage and management stratification for the best utilization of the health care resources. Primary Percutaneous Coronary Intervention (PCI) with early revascularization is a new emerging invasive technique and application of this technique is increasing tediously among the clinicians. However, the current body of evidences is divided between the efficacy, need and critical timing of PCI compared to conservative management in the treatment protocol for NSTEMI. A review of trials done comparing the early use of PCI versus conservative management indicates inconsistent finding with strong evidence towards early use of PCI in moderate to high-risk NSTEMI patients.
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Hasan et al. (2015) conducted a review in Non ST elevated myocardial infarction (NSTEMI). Early use of Primary Percutaneous Coronary Intervention (PCI) vs. Conservative management was evaluated. Early use of primary PCI compared to conservative management shows inconsistent findings overall, but strong evidence supports its early use in moderate to high-risk NSTEMI patients.
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