EBQ:Routine vs an Invasive strategy in ACS: Difference between revisions
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{{JC info | |||
| title= Routine vs Selective Invasive Strategies in Patients With Acute Coronary Syndromes | |||
| abbreviation= | |||
| expansion= Routine vs Selective Invasive Strategies in Patients With Acute Coronary Syndromes | |||
| published= 2005 | |||
| author= Mehta, Shamir et al | |||
| journal= JAMA | |||
| year= 2005 | |||
| volume= 293 | |||
| issue= 23 | |||
| pages= 2908-2917 | |||
| pmid= 15956636 | |||
| fulltexturl= http://jama.jamanetwork.com/article.aspx?articleid=201087 | |||
| pdfurl= http://jama.jamanetwork.com/data/Journals/JAMA/4980/JRV50012.pdf | |||
}} | |||
==Clinical Question== | |||
Does percutaneous coronary intervention (PCI) for all patients with unstable angina or Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) reduce death and recurrent myocardial infarction in comparison to only performing PCI in patient with recurrent or inducible ischemia | |||
==Conclusion== | |||
Routine PCI reduced recurrent MI, severe angina, and rehospitalization over a mean follow-up of 17 months when compared to a more conservative selective strategy of PCI. | |||
==Major Points== | |||
==Study Design== | |||
==Inclusion Criteria== | |||
==Exclusion Criteria== | |||
==Interventions== | |||
==Outcome== | |||
===Primary Outcomes=== | |||
===Secondary Outcomes=== | |||
===Subgroup analysis=== | |||
==Criticisms & Further Discussion== | |||
==Funding== | |||
==CME== | |||
<quiz display=simple> | |||
{Cardiovascular question: In the patient with an acute myocardial infarction and cardiogenic shock, which of the following constitutes optimal therapy? | |||
|type="()"} | |||
-ensure adequate ventilation and oxygenation | |||
-treat emergent arrhythmias | |||
-administer aspirin if not aspirin allergic | |||
-arrange for emergent PCI | |||
+All of the above | |||
||All of the above would be indicated, and consideration should be given for inotropic agents. Evidence from randomized trials suggests that emergent revascularization improves mortality rates at 6 months and one year. | |||
</quiz> | |||
==Sources== | |||
<references/> | |||
[[Category:EBQ]] | [[Category:EBQ]] | ||
Revision as of 05:35, 11 January 2014
incomplete Journal Club Article
Mehta, Shamir et al. "Routine vs Selective Invasive Strategies in Patients With Acute Coronary Syndromes". JAMA. 2005. 293(23):2908-2917.
PubMed Full text PDF
PubMed Full text PDF
Clinical Question
Does percutaneous coronary intervention (PCI) for all patients with unstable angina or Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) reduce death and recurrent myocardial infarction in comparison to only performing PCI in patient with recurrent or inducible ischemia
Conclusion
Routine PCI reduced recurrent MI, severe angina, and rehospitalization over a mean follow-up of 17 months when compared to a more conservative selective strategy of PCI.
Major Points
Study Design
Inclusion Criteria
Exclusion Criteria
Interventions
Outcome
Primary Outcomes
Secondary Outcomes
Subgroup analysis
Criticisms & Further Discussion
Funding
CME