Why the study?
Does a routine invasive strategy improve clinical outcomes in patients with UA/NSTEMI compared to a selective invasive strategy?
Population
8,915 participants with acute unstable angina and non-ST elevation myocardial infarction pooled from 8 RCTs
Comparison
Routine invasive strategy vs Selective invasive strategy
Design
Meta-analysis
Follow-up
6 to 12 months
Authors
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Supports selective over routine invasive strategy in UA/NSTEMI; confirms no mortality or death/MI benefit at 6-12 months.
Does a routine invasive strategy improve clinical outcomes in patients with UA/NSTEMI compared to a selective invasive strategy?
A routine invasive strategy for UA/NSTEMI does not reduce mortality at 6-12 months but reduces recurrent MI and re-hospitalisation at the cost of increased bleeding and procedure-related MI.
Fanning et al. (2016) studied this question.
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