מתוך medicontext.co.il
NEW YORK (Reuters Health) – In a large population-based cohort with a mean follow-up of 6 years, the early use of coronary angiography in the evaluation of patients with unstable angina was associated with a marked survival benefit.
Dr. Verghese Mathew of the Mayo Clinic in Rochester, Minnesota and colleagues report the finding in the American Heart Journal for November, noting that the value of early angiography in patients with unstable angina is controversial.
The investigators used the Olmsted County Acute Chest Pain Database to identify 2264 patients with unstable angina, 892 of whom underwent early coronary angiography. After adjusting for confounding baseline factors, early angiography was associated with a reduced 0.63 relative risk for all-cause mortality.
"The benefit appears greatest in those patients at greater risk for adverse cardiac events, underscoring the importance of clinical risk stratification of unstable angina patients," Dr. Mathew told Reuters Health.
These findings, the researcher added, "are in keeping with the FRISC II trial where a survival benefit with an early invasive strategy at 2 years has been reported thus far, and the TACTICS-TIMI 18 trial which demonstrated a reduction in a composite of cardiac events at 6 months."
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