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February 11, 2008Archives of Internal Medicine

Use of Cardiac Catheterization for Non–ST-Segment Elevation Acute Coronary Syndromes According to Initial RiskReasons Why Physicians Choose Not to Refer Their Patients

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Why the study?

Does referral for cardiac catheterization improve mortality in patients with NSTE ACS?

Population

2,136 patients with non-ST-segment elevation acute coronary syndromes from the prospective, observational…

Comparison

Referral for cardiac catheterization vs No referral for cardiac catheterization

Design

Cohort

Follow-up

1 year

Authors

CLCindy H. Lee

Discussion

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Overview

Catheterization associated with lower NSTE ACS mortality; leaves open causal benefit versus selection bias pending randomized trials.

Structured PICO

Does referral for cardiac catheterization improve mortality in patients with NSTE ACS?

P
Population
2,136 patients with non-ST-segment elevation (NSTE) acute coronary syndromes (ACS) from the prospective, observational Canadian ACS Registry II
I
Intervention
Referral for cardiac catheterization
C
Comparator
No referral for cardiac catheterization
O
Outcome
In-hospital and 1-year mortality rates, and rates of catheterization referral according to TIMI risk scorehard clinical

Cardiac catheterization is underutilized in higher-risk NSTE ACS patients due to physician misperception of risk, despite being associated with significantly lower in-hospital and 1-year mortality.

Cite This Study

Cindy H. Lee (2008) studied this question.

synapsesocial.com/papers/6a78c844c72ca19efaf995c0https://doi.org/10.1001/archinternmed.2007.78
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Also Consider

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

  1. 1ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction2007 · 1,857 citations
  2. 2Population rates of cardiac catheterization and yield of high-risk coronary artery disease2005 · 15 citations
  3. 3ST 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 substudy2002 · 135 citations
  4. 4FRISC score for selection of patients for an early invasive treatment strategy in unstable coronary artery disease2005 · 98 citations
  5. 5Comparison of Early Invasive and Conservative Strategies in Patients with Unstable Coronary Syndromes Treated with the Glycoprotein IIb/IIIa Inhibitor Tirofiban2001 · 2,116 citations