The long-term benefits are still unclear.
Should all patients with non-ST–elevation acute coronary syndromes (ACS) undergo early angiography and revascularization, or should angiography be reserved for patients with persistent angina or ischemia? Meta-analyses suggest that patients who undergo early angiography have lower rates of death or myocardial infarction after 2 years, but individual randomized trials have yielded inconsistent findings, and longer-term outcomes are still in doubt.
Investigators in the Netherlands randomized 1200 patients with non-ST–elevation ACS and elevated serum troponin T levels to angiography within 48 hours or to initial medical management and selective angiography. After 1 year, the primary composite endpoint of death, MI, or rehospitalization for angi…