|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 2002; 40:1902-1914 © 2002 by the American College of Cardiology Foundation |
* Department of Cardiology, University Hospital, Uppsala, Sweden
Department of Cardiology, University Hospital, Aarhus, Denmark
Heart and Lung Centre, Ullevål University Hospital, Oslo, Norway
Department of Cardiology, Heart Centre, University Hospital, Umeå, Sweden
|| Department of Thoracic Surgery, University Hospital, Uppsala, Sweden
¶ Department of Cardiology, University Hospital, Linköping, Sweden
Manuscript received January 31, 2002; revised manuscript received May 31, 2002, accepted July 11, 2002.
* Reprint requests and correspondence: Dr. Bo Lagerqvist, Department of Cardiology, University Hospital, S-751 85 Uppsala, Sweden.
bo.lagerqvist{at}card.uas.lul.se
OBJECTIVES: We sought to report the first and repeat events and to separate spontaneous and procedure-related events over two years in the Fast Revascularization during InStability in Coronary artery disease (FRISC-II) invasive trial.
BACKGROUND: The FRISC-II invasive trial compared the long-term effects of an early invasive versus noninvasive strategy, in terms of death and myocardial infarction (MI) and the need for repeat hospital admissions and late revascularization procedures in patients with coronary artery disease (UCAD).
METHODS: In the FRISC-II trial, 2,457 patients with UCAD were randomized to an early invasive or noninvasive strategy.
RESULTS: At 24 month follow-up, there were reductions in mortality (n = 45 [3.7%] vs. 67 [5.4%]; risk ratio 0.68 [95% confidence interval (CI) 0.47 to 0.98]; p = 0.038), MI (n = 111 [9.2%] vs. 156 [12.7%]; risk ratio 0.72 [95% CI 0.57 to 0.91]; p = 0.005), and the composite end point of death or MI (n = 146 [12.1%] vs. 200 [16.3%]; risk ratio 0.74 [95% CI 0.61 to 0.90]; p = 0.003) in the invasive compared with the noninvasive group. Procedure-related MIs were two to three times more common, but spontaneous ones were three times less common in the invasive than in the noninvasive group. After the first year, there was no difference in mortality (n = 20 [1.7%]) between the two groups and fewer MIs in the invasive group (p = 0.031).
CONCLUSIONS: In UCAD, the early invasive approach leads to a sustained reduction in mortality, cardiac morbidity, and the need for repeat hospital admissions and late revascularization procedures. Although the benefits are greatest during the first months, during the second year, cardiac morbidity is lower and the need for hospital care is less in the invasive group.
| ||||||||||||||
This article has been cited by other articles:
|
|
 |
|
  M. L. Brown, T. M. Sundt III, and B. J. Gersh Indications for Revascularization Card. Surg. Adult, January 1, 2008; 3(2008): 551 - 572. [Full Text]
|
|
|
|
 |
|
 K. C. Wollert, T. Kempf, B. Lagerqvist, B. Lindahl, S. Olofsson, T. Allhoff, T. Peter, A. Siegbahn, P. Venge, H. Drexler, et al. Growth Differentiation Factor 15 for Risk Stratification and Selection of an Invasive Treatment Strategy in Non ST-Elevation Acute Coronary Syndrome Circulation, October 2, 2007; 116(14): 1540 - 1548. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, J.-P. Bassand, C. W. Hamm, D. Ardissino, E. Boersma, A. Budaj, F. Fernandez-Aviles, K. A.A. Fox, D. Hasdai, E. M. Ohman, et al. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology Eur. Heart J., July 1, 2007; 28(13): 1598 - 1660. [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. V. d. Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: full text: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD) Eur. Heart J. Suppl., June 1, 2007; 9(suppl_C): C3 - C74. [Full Text] [PDF]
|
|
|
|
|
|
K. P. Alexander, L. K. Newby, C. P. Cannon, P. W. Armstrong, W. B. Gibler, M. W. Rich, F. Van de Werf, H. D. White, W. D. Weaver, M. D. Naylor, et al. Acute Coronary Care in the Elderly, Part I: Non-ST-Segment-Elevation Acute Coronary Syndromes: A Scientific Statement for Healthcare Professionals From the American Heart Association Council on Clinical Cardiology: In Collaboration With the Society of Geriatric Cardiology Circulation, May 15, 2007; 115(19): 2549 - 2569. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Held, P. Tornvall, and U. Stenestrand Effects of revascularization within 14 days of hospital admission due to acute coronary syndrome on 1-year mortality in patients with previous coronary artery bypass graft surgery Eur. Heart J., February 1, 2007; 28(3): 316 - 325. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. Van den Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD) Eur. Heart J., January 1, 2007; 28(1): 88 - 136. [Full Text] [PDF]
|
|
|
|
 |
|
 A. A. Bavry, D. J. Kumbhani, A. N. Rassi, D. L. Bhatt, and A. T. Askari Benefit of Early Invasive Therapy in Acute Coronary Syndromes: A Meta-Analysis of Contemporary Randomized Clinical Trials J. Am. Coll. Cardiol., October 3, 2006; 48(7): 1319 - 1325. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P A Poole-Wilson, S J Pocock, K A A Fox, R A Henderson, D J Wheatley, D A Chamberlain, T R D Shaw, T C Clayton, and for the Randomised Intervention Trial of unstable Interventional versus conservative treatment in acute non-ST elevation coronary syndrome: time course of patient management and disease events over one year in the RITA 3 trial Heart, October 1, 2006; 92(10): 1473 - 1479. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. de Winter Commentary on Clinical Guidelines and Practice: In Search of the Truth by Dean J. Kereiakes and Elliott M. Antman J. Am. Coll. Cardiol., September 19, 2006; 48(6): 1136 - 1138. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Malarstig, B. Lindahl, L. Wallentin, and A. Siegbahn Soluble CD40L Levels Are Regulated by the -3459 A>G Polymorphism and Predict Myocardial Infarction and the Efficacy of Antithrombotic Treatment in Non-ST Elevation Acute Coronary Syndrome Arterioscler. Thromb. Vasc. Biol., July 1, 2006; 26(7): 1667 - 1673. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Popescu, M. S. Vaughan-Sarrazin, and G. E. Rosenthal Certificate of need regulations and use of coronary revascularization after acute myocardial infarction. JAMA, May 10, 2006; 295(18): 2141 - 2147. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. de Winter, F. Windhausen, J. H. Cornel, P. H.J.M. Dunselman, C. L. Janus, P. E.F. Bendermacher, H. R. Michels, G. T. Sanders, J. G.P. Tijssen, F. W.A. Verheugt, et al. Early Invasive versus Selectively Invasive Management for Acute Coronary Syndromes N. Engl. J. Med., September 15, 2005; 353(11): 1095 - 1104. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R. Mehta, C. P. Cannon, K. A. A. Fox, L. Wallentin, W. E. Boden, R. Spacek, P. Widimsky, P. A. McCullough, D. Hunt, E. Braunwald, et al. Routine vs Selective Invasive Strategies in Patients With Acute Coronary Syndromes: A Collaborative Meta-analysis of Randomized Trials JAMA, June 15, 2005; 293(23): 2908 - 2917. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Stukel, F. L. Lucas, and D. E. Wennberg Long-term Outcomes of Regional Variations in Intensity of Invasive vs Medical Management of Medicare Patients With Acute Myocardial Infarction JAMA, March 16, 2005; 293(11): 1329 - 1337. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Labinaz, J. Mathias, K. Pieper, C. B. Granger, A. M. Lincoff, D. J. Moliterno, F. Van de Werf, J. Simes, H. D. White, M. L. Simoons, et al. Outcomes of patients with acute coronary syndromes and prior percutaneous coronary intervention: a pooled analysis of three randomized clinical trials Eur. Heart J., January 2, 2005; 26(2): 128 - 136. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. A. Harrington, R. C. Becker, M. Ezekowitz, T. W. Meade, C. M. O'Connor, D. A. Vorchheimer, and G. H. Guyatt Antithrombotic Therapy for Coronary Artery Disease: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy Chest, September 1, 2004; 126(3_suppl): 513S - 548S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. I. Larsen and K. Dickstein BNP in acute coronary syndromes: the heart expresses its suffering Eur. Heart J., August 1, 2004; 25(15): 1284 - 1286. [Full Text] [PDF]
|
|
|
|
 |
|
 D. V. Nagarajan, P. S. Lewis, M. Maguire, and J. Dunning Is an early invasive approach superior to a conservative strategy in patients with acute coronary syndrome? Interactive CardioVascular and Thoracic Surgery, June 1, 2004; 3(2): 363 - 367. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Mukherjee, J. Fang, S. Chetcuti, M. Moscucci, E. Kline-Rogers, and K. A. Eagle Impact of Combination Evidence-Based Medical Therapy on Mortality in Patients With Acute Coronary Syndromes Circulation, February 17, 2004; 109(6): 745 - 749. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Jernberg, B. Lindahl, A. Siegbahn, B. Andren, G. Frostfeldt, B. Lagerqvist, M. Stridsberg, P. Venge, and L. Wallentin N-terminal pro-brain natriuretic peptide in relation to inflammation, myocardial necrosis, and the effect of an invasive strategy in unstable coronary artery disease J. Am. Coll. Cardiol., December 3, 2003; 42(11): 1909 - 1916. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 ADDITIONAL ARTICLES ABSTRACTED IN ACP JOURNAL CLUB Evid. Based Med., September 1, 2003; 8(5): 131 - 131. [Full Text] [PDF]
|
|
|
|
|
|
J Gunn and D P Taggart Revascularisation for acute coronary syndromes: PCI or CABG? Heart, September 1, 2003; 89(9): 967 - 970. [Full Text] [PDF]
|
|
|
|
|
|
P. A. Lemos, C.-h. Lee, M. Degertekin, F. Saia, K. Tanabe, C. A. Arampatzis, A. Hoye, M. van Duuren, G. Sianos, P. C. Smits, et al. Early outcome after sirolimus-eluting stent implantation in patients with acute coronary syndromes: Insights from the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) registry J. Am. Coll. Cardiol., June 4, 2003; 41(11): 2093 - 2099. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Persistent Benefits of Early PCI for Acute Coronary Syndromes Journal Watch Emergency Medicine, January 15, 2003; 2003(115): 3 - 3. [Full Text]
|
|
|
|
|
|
R. K. Yarlagadda and W. E. Boden Cardioprotective effects of an early invasive strategy for non-ST-segment elevationacute coronary syndromes: Are we all becoming "interventional" cardiologists? J. Am. Coll. Cardiol., December 4, 2002; 40(11): 1915 - 1918. [Full Text] [PDF]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
