Percutaneous coronary intervention unstable Angina/non-ST-elevation myocardial infarction: Difference between revisions

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(/* ACC / AHA 2011 Guidelines for Percutaneous Coronary Intervention: Coronary angiography strategies in patients of Unstable Angina/NSTEMI{{cite journal |author=Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis...)
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==2011 ACCF/AHA/SCAI Guidelines for Percutaneous Coronary Intervention (DO NOT EDIT)<ref name="pmid22070837">{{cite journal |author=Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH |title=2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions |journal=[[Journal of the American College of Cardiology]] |volume=58 |issue=24|pages=2550–83|year=2011|month=December|pmid=22070837|doi=10.1016/j.jacc.2011.08.006|url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)02875-0|accessdate=2011-12-08|url=http://content.onlinejacc.org/cgi/reprint/58/24/2550.pdf|PDF}}</ref>==
==ACCF/AHA/SCAI 2011 Guidelines for Percutaneous Coronary Intervention: Coronary angiography strategies in patients of Unstable Angina/NSTEMI<ref name="pmid22070837">{{cite journal |author=Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH |title=2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions |journal=[[Journal of the American College of Cardiology]] |volume=58 |issue=24 |pages=2550–83 |year=2011 |month=December|pmid=22070837|doi=10.1016/j.jacc.2011.08.006|url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)02875-0|accessdate=2011-12-08|url=http://content.onlinejacc.org/cgi/reprint/58/24/2550.pdf|PDF}}</ref> (DO NOT EDIT)==
===PCI in patients of Unstable Angina/NSTEMI (DO NOT EDIT)<ref name="pmid22070837">{{cite journal |author=Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH |title=2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions |journal=[[Journal of the American College of Cardiology]] |volume=58 |issue=24 |pages=2550–83|year=2011|month=December|pmid=22070837|doi=10.1016/j.jacc.2011.08.006|url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)02875-0|accessdate=2011-12-08|url=http://content.onlinejacc.org/cgi/reprint/58/24/2550.pdf|PDF}}</ref>===
 
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<nowiki>"</nowiki>'''1.''' An early invasive strategy (i.e., diagnostic angiography with intent to perform revascularization) is indicated in [[UA|UA/NSTEMI]] patients who have refractory angina or hemodynamic or electrical instability (without serious comorbidities or contraindications to such procedures).<ref name="pmid17010789">Bavry AA, Kumbhani DJ, Rassi AN, Bhatt DL, Askari AT (2006)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17010789 Benefit of early invasive therapy in acute coronary syndromes: a meta-analysis of contemporary randomized clinical trials.] ''J Am Coll Cardiol'' 48 (7):1319-25.  [http://dx.doi.org/10.1016/j.jacc.2006.06.050DOI:10.1016/j.jacc.2006.06.050] PMID: [http://pubmed.gov/17010789 17010789]</ref><ref name="pmid11419424">Cannon CP, Weintraub WS, Demopoulos LA, Vicari R, Frey MJ, Lakkis N et al. (2001) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11419424 Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban.] ''N Engl J Med'' 344 (25):1879-87.[http://dx.doi.org/10.1056/NEJM200106213442501 DOI:10.1056/NEJM200106213442501] PMID:[http://pubmed.gov/11419424 11419424]</ref><ref name="pmid20359842">Fox KA, Clayton TC, Damman P, Pocock SJ, de Winter RJ, Tijssen JG et al. (2010)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=20359842 Long-term outcome of a routine versus selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome a meta-analysis of individual patient data.] ''J Am Coll Cardiol'' 55 (22):2435-45.[http://dx.doi.org/10.1016/j.jacc.2010.03.007 DOI:10.1016/j.jacc.2010.03.007] PMID:[http://pubmed.gov/20359842 20359842]</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
<nowiki>"</nowiki>'''1.''' An early invasive strategy (i.e., diagnostic angiography with intent to perform revascularization) is indicated in UA/NSTEMI patients who have refractory angina or hemodynamic or electrical instability (without serious comorbidities or contraindications to such procedures).<ref name="pmid17010789">Bavry AA, Kumbhani DJ, Rassi AN, Bhatt DL, Askari AT (2006)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17010789 Benefit of early invasive therapy in acute coronary syndromes: a meta-analysis of contemporary randomized clinical trials.] ''J Am Coll Cardiol'' 48 (7):1319-25.  [http://dx.doi.org/10.1016/j.jacc.2006.06.050DOI:10.1016/j.jacc.2006.06.050] PMID: [http://pubmed.gov/17010789 17010789]</ref><ref name="pmid11419424">Cannon CP, Weintraub WS, Demopoulos LA, Vicari R, Frey MJ, Lakkis N et al. (2001)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11419424 Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban.] ''N Engl J Med'' 344 (25):1879-87.[http://dx.doi.org/10.1056/NEJM200106213442501 DOI:10.1056/NEJM200106213442501]PMID:[http://pubmed.gov/1141942411419424]</ref><ref name="pmid20359842">Fox KA, Clayton TC, Damman P, Pocock SJ, de Winter RJ, Tijssen JG et al. (2010)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=20359842 Long-term outcome of a routine versus selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome a meta-analysis of individual patient data.] ''J Am Coll Cardiol'' 55 (22):2435-45.[http://dx.doi.org/10.1016/j.jacc.2010.03.007DOI:10.1016/j.jacc.2010.03.007]PMID:[http://pubmed.gov/20359842 20359842]</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
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<nowiki>"</nowiki>'''2.''' An early invasive strategy (i.e., diagnostic angiography with intent to perform revascularization) is indicated in initially stabilized [[UA|UA/NSTEMI]] patients (without serious comorbidities or contraindications to such procedures) who have an elevated risk for clinical events.<ref name="pmid11419424">Cannon CP, Weintraub WS, Demopoulos LA, Vicari R, Frey MJ, Lakkis N et al. (2001) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11419424 Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban.] ''N Engl J Med'' 344 (25):1879-87.[http://dx.doi.org/10.1056/NEJM200106213442501 DOI:10.1056/NEJM200106213442501] PMID:[http://pubmed.gov/11419424 11419424]</ref><ref name="pmid20359842">Fox KA, Clayton TC, Damman P, Pocock SJ, de Winter RJ, Tijssen JG et al. (2010)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=20359842 Long-term outcome of a routine versus selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome a meta-analysis of individual patient data.] ''J Am Coll Cardiol'' 55 (22):2435-45.[http://dx.doi.org/10.1016/j.jacc.2010.03.007 DOI:10.1016/j.jacc.2010.03.007] PMID:[http://pubmed.gov/20359842 20359842]</ref><ref name="pmid10475181"> (1999)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10475181 Invasive compared with non-invasive treatment in unstable coronary-artery disease: FRISC II prospective randomised multicentre study. FRagmin and Fast Revascularisation during InStability in Coronary artery disease Investigators.] ''Lancet'' 354 (9180):708-15. PMID: [http://pubmed.gov/10475181 10475181]</ref><ref name="pmid19458363">Mehta SR, Granger CB, Boden WE, Steg PG, Bassand JP, Faxon DP et al. (2009)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19458363 Early versus delayed invasive intervention in acute coronary syndromes.] ''N Engl J Med'' 360 (21):2165-75.[http://dx.doi.org/10.1056/NEJMoa0807986 DOI:10.1056/NEJMoa0807986] PMID:[http://pubmed.gov/19458363 19458363]</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
<nowiki>"</nowiki>'''2.''' An early invasive strategy (i.e., diagnostic [[angiography]] with intent to perform revascularization) is indicated in initially stabilized UA/NSTEMI patients (without serious comorbidities or contraindications to such procedures) who have an elevated risk for clinical events.<ref name="pmid11419424">Cannon CP, Weintraub WS, Demopoulos LA, Vicari R, Frey MJ, Lakkis N et al. (2001)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11419424 Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban.] ''N Engl J Med'' 344 (25):1879-87.[http://dx.doi.org/10.1056/NEJM200106213442501 DOI:10.1056/NEJM200106213442501]PMID:[http://pubmed.gov/1141942411419424]</ref><ref name="pmid20359842">Fox KA, Clayton TC, Damman P, Pocock SJ, de Winter RJ, Tijssen JG et al. (2010)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=20359842 Long-term outcome of a routine versus selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome a meta-analysis of individual patient data.] ''J Am Coll Cardiol'' 55 (22):2435-45.[http://dx.doi.org/10.1016/j.jacc.2010.03.007DOI:10.1016/j.jacc.2010.03.007]PMID:[http://pubmed.gov/20359842 20359842]</ref><ref name="pmid10475181">(1999)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10475181 Invasive compared with non-invasive treatment in unstable coronary-artery disease: FRISC II prospective randomised multicentre study. FRagmin and Fast Revascularisation during InStability in Coronary artery disease Investigators.]''Lancet'' 354 (9180):708-15. PMID: [http://pubmed.gov/1047518110475181]</ref><ref name="pmid19458363">Mehta SR, Granger CB, Boden WE, Steg PG, Bassand JP, Faxon DP et al. (2009)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19458363Early versus delayed invasive intervention in acute coronary syndromes.] ''N Engl J Med'' 360 (21):2165-75.[http://dx.doi.org/10.1056/NEJMoa0807986DOI:10.1056/NEJMoa0807986] PMID:[http://pubmed.gov/19458363 19458363]</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
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<nowiki>"</nowiki>'''3.''' The selection of PCI or CABG as the means of revascularization in the patient with [[acute coronary syndrome]] ([[ACS]]) should generally be based on the same considerations as those without ACS.<ref name="pmid8622299">Jones RH, Kesler K, Phillips HR, Mark DB, Smith PK, Nelson CL et al. (1996) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8622299 Long-term survival benefits of coronary artery bypass grafting and percutaneous transluminal angioplasty in patients with coronary artery disease.]''J Thorac Cardiovasc Surg'' 111 (5):1013-25. PMID: [http://pubmed.gov/8622299 8622299]</ref><ref name="pmid20359842">Fox KA, Clayton TC, Damman P, Pocock SJ, de Winter RJ, Tijssen JG et al. (2010)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=20359842 Long-term outcome of a routine versus selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome a meta-analysis of individual patient data.] ''J Am Coll Cardiol'' 55 (22):2435-45.[http://dx.doi.org/10.1016/j.jacc.2010.03.007 DOI:10.1016/j.jacc.2010.03.007] PMID:[http://pubmed.gov/20359842 20359842]</ref><ref name="pmid16098419">Rodriguez AE, Baldi J, Fernández Pereira C, Navia J, Rodriguez Alemparte M, Delacasa A et al. (2005)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16098419 Five-year follow-up of the Argentine randomized trial of coronary angioplasty with stenting versus coronary bypass surgery in patients with multiple vessel disease (ERACI II).] ''J Am Coll Cardiol'' 46 (4):582-8.[http://dx.doi.org/10.1016/j.jacc.2004.12.081 DOI:10.1016/j.jacc.2004.12.081] PMID:[http://pubmed.gov/16098419 16098419]</ref><ref name="pmid17258088">Valgimigli M, Dawkins K, Macaya C, de Bruyne B, Teiger E, Fajadet J et al. (2007)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17258088 Impact of stable versus unstable coronary artery disease on 1-year outcome in elective patients undergoing multivessel revascularization with sirolimus-eluting stents: a subanalysis of the ARTS II trial.] ''J Am Coll Cardiol'' 49 (4):431-41.[http://dx.doi.org/10.1016/j.jacc.2006.06.081 DOI:10.1016/j.jacc.2006.06.081] PMID:[http://pubmed.gov/17258088 17258088]</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
<nowiki>"</nowiki>'''3.''' The selection of [[PCI]] or [[CABG]] as the means of revascularization in the patient with [[acute coronary syndrome]]([[ACS]]) should generally be based on the same considerations as those without ACS.<ref name="pmid8622299">Jones RH, Kesler K, Phillips HR, Mark DB, Smith PK, Nelson CL et al. (1996) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8622299 Long-term survival benefits of coronary artery bypass grafting and percutaneous transluminal angioplasty in patients with coronary artery disease.]''J Thorac Cardiovasc Surg'' 111 (5):1013-25. PMID:[http://pubmed.gov/86222998622299]</ref><ref name="pmid20359842">Fox KA, Clayton TC, Damman P, Pocock SJ, de Winter RJ, Tijssen JG et al. (2010)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=20359842 Long-term outcome of a routine versus selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome a meta-analysis of individual patient data.] ''J Am Coll Cardiol'' 55 (22):2435-45.[http://dx.doi.org/10.1016/j.jacc.2010.03.007DOI:10.1016/j.jacc.2010.03.007]PMID:[http://pubmed.gov/20359842 20359842]</ref><ref name="pmid16098419">Rodriguez AE, Baldi J, Fernández Pereira C, Navia J, Rodriguez Alemparte M, Delacasa A et al. (2005)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16098419Five-year follow-up of the Argentine randomized trial of coronary angioplasty with stenting versus coronary bypass surgery in patients with multiple vessel disease (ERACI II).] ''J Am Coll Cardiol'' 46 (4):582-8.[http://dx.doi.org/10.1016/j.jacc.2004.12.081DOI:10.1016/j.jacc.2004.12.081] PMID:[http://pubmed.gov/16098419 16098419]</ref><ref name="pmid17258088">Valgimigli M, Dawkins K, Macaya C, de Bruyne B, Teiger E, Fajadet J et al. (2007)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17258088 Impact of stable versus unstable coronary artery disease on 1-year outcome in elective patients undergoing multivessel revascularization with sirolimus-eluting stents: a subanalysis of the ARTS II trial.] ''J Am Coll Cardiol'' 49 (4):431-41.[http://dx.doi.org/10.1016/j.jacc.2006.06.081DOI:10.1016/j.jacc.2006.06.081] PMID:[http://pubmed.gov/17258088 17258088]</ref>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
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Latest revision as of 20:21, 1 November 2012

Percutaneous Coronary Intervention Guidelines Microchapters

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Patient Information

Overview

PCI Approaches:

CAD Revascularization:

Heart Team Approach to Revascularization Decisions
Left Main Coronary Artery Disease
Intervention in left main coronary artery disease
Non-Left Main Coronary Artery Disease
Revascularization to Improve Symptoms
Dual Antiplatelet Therapy Compliance and Stent Thrombosis
Hybrid Coronary Revascularization

Pre-procedural Considerations:

Contrast-Induced Acute Kidney Injury
Anaphylactoid Reactions
Statin Treatment
Bleeding Risk
Role of Onsite Surgical Backup

Procedural Considerations:

Vascular Access
PCI in Specific Clinical Situations:
Asymptomatic Ischemia or CCS Class I or II Angina
CCS Class III Angina
Unstable Angina/Non–ST-Elevation Myocardial Infarction
ST-Elevation Myocardial Infarction:
General and Specific Considerations
Coronary Angiography Strategies in STEMI
Primary PCI of the Infarct Artery
Delayed or Elective PCI in patients with STEMI
Fibrinolytic-Ineligible Patients
Facilitated PCI
Rescue PCI
After Successful Fibrinolysis or for Patients Not Undergoing Primary Reperfusion
Cardiogenic Shock
Prior Coronary Bypass Surgery
Revascularization Before Non-cardiac Surgery
Adjunctive Diagnostic Devices:
Fractional Flow Reserve
Intravascular Ultrasound
Adjunctive Therapeutic Devices:
Coronary Atherectomy
Thrombectomy
Laser Angioplasty
Cutting Balloon Angioplasty
Embolic Protection Devices
Percutaneous Hemodynamic Support Devices
Antiplatelet therapy:
Oral Antiplatelet Therapy
Glycoprotein IIb/IIIa Receptor Antagonists
Intravenous Antiplatelet therapy:
STEMI
UA/NSTEMI
SIHD
Anticoagulant Therapy:
Parenteral Anticoagulants During PCI
Unfractionated Heparin
Enoxaparin
Bivalirudin and Argatroban
Fondaparinux
No-Reflow Pharmacological Therapies
PCI in Specific Anatomic Situations:
Chronic Total Occlusions
Saphenous Vein Grafts
Bifurcation Lesions
Aorto-Ostial Stenoses
Calcified Lesions
PCI in Specific Patient Populations:
Chronic Kidney Disease
Peri-procedural Myocardial Infarction Assessment
Vascular Closure Devices

Post-Procedural Considerations:

Post-procedural Antiplatelet Therapy
Proton Pump Inhibitors and Antiplatelet Therapy
Clopidogrel Genetic Testing
Platelet Function Testing
Restenosis
Exercise Testing
Cardiac Rehabilitation

Quality and Performance Considerations:

Quality and Performance
Certification and Maintenance of Certification
Operator and Institutional Competency and Volume

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [9]

2011 ACCF/AHA/SCAI Guidelines for Percutaneous Coronary Intervention (DO NOT EDIT)[1]

PCI in patients of Unstable Angina/NSTEMI (DO NOT EDIT)[1]

Class I

"1. An early invasive strategy (i.e., diagnostic angiography with intent to perform revascularization) is indicated in UA/NSTEMI patients who have refractory angina or hemodynamic or electrical instability (without serious comorbidities or contraindications to such procedures).[2][3][4] (Level of Evidence: B)"

"2. An early invasive strategy (i.e., diagnostic angiography with intent to perform revascularization) is indicated in initially stabilized UA/NSTEMI patients (without serious comorbidities or contraindications to such procedures) who have an elevated risk for clinical events.[3][4][5][6] (Level of Evidence: A)"

"3. The selection of PCI or CABG as the means of revascularization in the patient with acute coronary syndrome(ACS) should generally be based on the same considerations as those without ACS.[7][4][8][9](Level of Evidence: B)"

Class III (No Benefit)

"1. An early invasive strategy (i.e., diagnostic angiography with intent to perform revascularization) is not recommended in patients with extensive co-morbidities (e.g., liver or pulmonary failure, cancer) in whom:

a. The risks of revascularization and comorbid conditions are likely to outweigh the benefits of revascularization, (Level of Evidence: C)
b. There is a low likelihood of ACS despite acute chest pain, or (Level of Evidence: C)
c. Consent to revascularization will not be granted regardless of the findings. (Level of Evidence: C)"

References

  1. ↑ 1.0 1.1 Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH (2011). "2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions" (PDF). Journal of the American College of Cardiology. 58 (24): 2550–83. doi:10.1016/j.jacc.2011.08.006. PMID 22070837. Retrieved 2011-12-08. Text "PDF" ignored (help); Unknown parameter |month= ignored (help)
  2. ↑ Bavry AA, Kumbhani DJ, Rassi AN, Bhatt DL, Askari AT (2006)Benefit of early invasive therapy in acute coronary syndromes: a meta-analysis of contemporary randomized clinical trials. J Am Coll Cardiol 48 (7):1319-25. [1] PMID: 17010789
  3. ↑ 3.0 3.1 Cannon CP, Weintraub WS, Demopoulos LA, Vicari R, Frey MJ, Lakkis N et al. (2001)Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban. N Engl J Med 344 (25):1879-87.DOI:10.1056/NEJM200106213442501PMID:[2]
  4. ↑ 4.0 4.1 4.2 Fox KA, Clayton TC, Damman P, Pocock SJ, de Winter RJ, Tijssen JG et al. (2010)Long-term outcome of a routine versus selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome a meta-analysis of individual patient data. J Am Coll Cardiol 55 (22):2435-45.[3]PMID:20359842
  5. ↑ (1999)Invasive compared with non-invasive treatment in unstable coronary-artery disease: FRISC II prospective randomised multicentre study. FRagmin and Fast Revascularisation during InStability in Coronary artery disease Investigators.Lancet 354 (9180):708-15. PMID: [4]
  6. ↑ Mehta SR, Granger CB, Boden WE, Steg PG, Bassand JP, Faxon DP et al. (2009)versus delayed invasive intervention in acute coronary syndromes. N Engl J Med 360 (21):2165-75.[5] PMID:19458363
  7. ↑ Jones RH, Kesler K, Phillips HR, Mark DB, Smith PK, Nelson CL et al. (1996) Long-term survival benefits of coronary artery bypass grafting and percutaneous transluminal angioplasty in patients with coronary artery disease.J Thorac Cardiovasc Surg 111 (5):1013-25. PMID:[6]
  8. ↑ Rodriguez AE, Baldi J, Fernández Pereira C, Navia J, Rodriguez Alemparte M, Delacasa A et al. (2005)follow-up of the Argentine randomized trial of coronary angioplasty with stenting versus coronary bypass surgery in patients with multiple vessel disease (ERACI II). J Am Coll Cardiol 46 (4):582-8.[7] PMID:16098419
  9. ↑ Valgimigli M, Dawkins K, Macaya C, de Bruyne B, Teiger E, Fajadet J et al. (2007)Impact of stable versus unstable coronary artery disease on 1-year outcome in elective patients undergoing multivessel revascularization with sirolimus-eluting stents: a subanalysis of the ARTS II trial. J Am Coll Cardiol 49 (4):431-41.[8] PMID:17258088

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