Rates of angina could be halved if interventions such as balloon angioplasty or coronary artery bypass surgery are undertaken soon after identification of patients at moderate risk of myocardial infarction.
The multi-center British Heart Foundation Randomised Intervention Trial of Unstable Angina (RITA) shows, like previous trials, that “the hazards of intervention seem to be more than counterbalanced by the subsequent reduction in risk of heart attack,” declares lead author Dr Keith Fox of the University of Edinburgh.
The most appropriate revascularisation strategy after presentation with unstable angina or non-ST-segment-elevation myocardial infarction remains contentious for patients at moderate risk, the researchers point out: “The American Heart Association/American College of Cardiology (AHA/ACC) guidelines recommend an invasive strategy for patients at high risk, but specify that either an invasive strategy or a conservative strategy is appropriate for patients at moderate or low risk.”
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