Invasive vs. Conservative Management of NSTEACS

One-year results from the ICTUS trial should be placed in the context of 5-year results from the RITA-3 trial.

Recent studies generally have supported an early invasive approach (routine angiography and, when indicated, revascularization) in patients with non–ST-segment-elevation acute coronary syndromes (NSTEACS; Journal Watch Cardiology Jul 29 2005). The partially industry-supported ICTUS trial from the Netherlands further tested this strategy.

Twelve hundred NSTEACS patients with recent symptoms and elevated troponin T levels were initially treated with aspirin and enoxaparin before random assignment to one of two strategies: an early invasive strategy within 48 hours that included abciximab for PCI or a conservative, selectively invasive strategy (revascularization only for refractory angina despite medical treatment, hemodynamic or rhythmic inst…

Reviewing Author

Howard C. Herrmann, MD