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ABOARD randomised controlled trial
No difference in peak troponin level in immediate versus delayed (next working day) intervention for acute coronary syndrome without ST-segment elevation
  1. Christopher B. Granger
  1. Christopher B. Granger
    Box 3409, Duke University Medical Center, Durham, NC 27710, USA; grang001{at}mc.duke.edu

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Patients with high-risk acute coronary syndromes have been shown to benefit from a strategy of early invasive catheterisation, and this is reflected in the US and European guidelines. However, the recently reported long-term follow-up from the Invasive versus Conservative Treatment in Unstable Coronary Syndromes (ICTUS) trial shows that even patients with elevated troponin may not benefit substantially from an early invasive strategy, compared with a “selective invasive” strategy, in the context of optimum medical therapy.1 Selected trials have suggested benefits from very early routine catheterisation,2 ,3 particularly among high-risk patients,3 although it remains unclear whether immediate catheterisation and revascularisation has measurable benefits compared with the more convenient approach …

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