Possible Benefit to Survival from Early Invasive Strategies in Patients with Acute Coronary Syndromes
Authors: Rehan Qayyum, Jurga Adomaityte, M. Rizwan Khalid
Journal: Annals of Internal Medicine (2008)

Letters3 June 2008Possible Benefit to Survival from Early Invasive Strategies in Patients with Acute Coronary SyndromesRehan Qayyum, MD, Jurga Adomaityte, MD, and M. Rizwan Khalid, MDRehan Qayyum, MDFrom Johns Hopkins School of Medicine, Baltimore, MD 21287, and New York Hospital Queens, Flushing, NY 11355.Search for more papers by this author, Jurga Adomaityte, MDFrom Johns Hopkins School of Medicine, Baltimore, MD 21287, and New York Hospital Queens, Flushing, NY 11355.Search for more papers by this author, and M. Rizwan Khalid, MDFrom Johns Hopkins School of Medicine, Baltimore, MD 21287, and New York Hospital Queens, Flushing, NY 11355.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-11-200806030-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Drs. Kumbhani and Bavry's interest in our systematic review. They suggest that excluding 3 trials (TIMI IIIB, VANQWISH, and MATE) that were performed before the current era of glycoprotein IIb/IIIa and coronary stenting would yield different results. When we excluded these 3 trials from meta-analyses, our results did not change (relative risk for death, 0.88 [95% CI, 0.72 to 1.07]; for nonfatal myocardial infarction, 0.82 [CI, 0.57 to 1.17]; and for combined death and nonfatal myocardial infarction, 0.84 [CI, 0.63 to 1.10]).The discrepancy between our results and the 2 meta-analyses (1, 2) by Bavry and ...References1. Bavry AA, Kumbhani DJ, Quiroz R, Ramchandani SR, Kenchaiah S, Antman EM. Invasive therapy along with glycoprotein IIb/IIIa inhibitors and intracoronary stents improves survival in non-ST-segment elevation acute coronary syndromes: a meta-analysis and review of the literature. Am J Cardiol. 2004;93:830-5. [PMID: 15050484] CrossrefMedlineGoogle Scholar2. Bavry AA, Kumbhani DJ, Rassi AN, Bhatt DL, Askari AT. Benefit of early invasive therapy in acute coronary syndromes: a meta-analysis of contemporary randomized clinical trials. J Am Coll Cardiol. 2006;48:1319-25. [PMID: 17010789] CrossrefMedlineGoogle Scholar3. Neumann FJ, Kastrati A, Pogatsa-Murray G, Mehilli J, Bollwein H, Bestehorn HP, et al. Evaluation of prolonged antithrombotic pretreatment (“cooling-off” strategy) before intervention in patients with unstable coronary syndromes: a randomized, controlled trial. JAMA. 2003;290:1593-9. [PMID: 14506118] CrossrefMedlineGoogle Scholar4. Hirsch A, Windhausen F, Tijssen JG, Verheugt FW, Cornel JH, de Winter RJ; Invasive versus Conservative Treatment in Unstable coronary Syndromes (ICTUS) investigators. Long-term outcome after an early invasive versus selective invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome and elevated cardiac troponin T (the ICTUS trial): a follow-up study. Lancet. 2007;369:827-35. [PMID: 17350451] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Johns Hopkins School of Medicine, Baltimore, MD 21287, and New York Hospital Queens, Flushing, NY 11355.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Review: Comparing Routine and Selective Invasive Strategies for the Acute Coronary Syndrome Rehan Qayyum , M. Rizwan Khalid , Jurga Adomaityte , Stylianos P. Papadakos , and Frank C. Messineo Possible Benefit to Survival from Early Invasive Strategies in Patients with Acute Coronary Syndromes Dharam J. Kumbhani and Anthony A. Bavry Metrics 3 June 2008Volume 148, Issue 11Page: 884KeywordsConflicts of interestCoronary stentingDrug therapyGlycoproteinsMyocardial infarctionPatientsStatinsStent implantationSystematic reviews ePublished: 3 June 2008 Issue Published: 3 June 2008 CopyrightCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...