Difference between revisions of "EBQ:Routine vs an Invasive strategy in ACS"

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PMID 15956636
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{{JC info
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| title=  Routine vs Selective Invasive Strategies in Patients With Acute Coronary Syndromes
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| abbreviation= 
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| expansion= Routine vs Selective Invasive Strategies in Patients With Acute Coronary Syndromes
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| published=  2005
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| author= Mehta, Shamir et al
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| journal=  JAMA
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| year=  2005
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| volume= 293
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| issue= 23
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| pages= 2908-2917
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| pmid= 15956636
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| fulltexturl= http://jama.jamanetwork.com/article.aspx?articleid=201087
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| pdfurl= http://jama.jamanetwork.com/data/Journals/JAMA/4980/JRV50012.pdf
 +
}}
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==Clinical Question==
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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
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 +
==Conclusion==
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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.
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==Major Points==
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==Study Design==
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==Inclusion Criteria==
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==Exclusion Criteria==
 +
 +
 
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==Interventions==
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==Outcome==
 +
 +
 
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===Primary Outcomes===
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 +
 
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===Secondary Outcomes===
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 +
 +
 
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===Subgroup analysis===
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 +
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==Criticisms & Further Discussion==
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 +
 
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==Funding==
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==CME==
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<quiz display=simple>
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{Cardiovascular question: In the patient with an acute myocardial infarction and cardiogenic shock, which of the following constitutes optimal therapy?
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|type="()"}
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-ensure adequate ventilation and oxygenation
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-treat emergent arrhythmias
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-administer aspirin if not aspirin allergic
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-arrange for emergent PCI
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+All of the above
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||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.
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</quiz>
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==Sources==
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<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

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

Cardiovascular question: In the patient with an acute myocardial infarction and cardiogenic shock, which of the following constitutes optimal therapy?

ensure adequate ventilation and oxygenation
treat emergent arrhythmias
administer aspirin if not aspirin allergic
arrange for emergent PCI
All of the above


Sources