Invasive Strategy for NSTEACS: Long-Term Benefits

The optimal management strategy for patients with non–ST-segment-elevation acute coronary syndromes (NSTEACS) continues to be debated. Routine early invasive therapy has been associated with increased risk for death and MI in the hospital but with reduced cumulative risk by short-term follow-up, compared with a selective-invasive strategy (Journal Watch Cardiology Jul 29 2005). A typical selectively invasive strategy involves initial medical treatment, then revascularization only for recurrent symptoms or evidence of inducible ischemia. The partially industry-supported, randomized RITA-3 trial from Great Britain addressed whether the advantage of early invasive management over more conservative management is sustained in the longer term. Su…