TY - JOUR T1 - Early invasive strategy in patients with non-ST segment elevation acute coronary syndrome delays death or MI by 18 months JF - Evidence Based Medicine JO - Evid Based Med SP - 97 LP - 97 DO - 10.1136/ebmed-2016-110642 VL - 22 IS - 3 AU - Robert Henderson Y1 - 2017/06/01 UR - http://ebm.bmj.com/content/22/3/97.abstract N2 - Commentary on: Wallentin L, Lindhagen L, Ärnström E, et al. Early invasive versus non-invasive treatment in patients with non-ST-elevation acute coronary syndrome (FRISC-II): 15 year follow-up of a prospective, randomised, multicentre study. Lancet 2016;388:1903–11.The role of coronary arteriography in patients with non-ST segment elevation acute coronary syndrome is controversial. Many cardiologists advocate a ‘routine invasive strategy’, which comprises coronary arteriography within a few days of presentation and myocardial revascularisation determined by the angiographic findings, but this exposes patients to procedural risks and incurs significant costs. Other clinicians favour a ‘selective invasive strategy’, with coronary arteriography reserved for patients with recurrent myocardial ischaemia.Randomised trials of these treatment strategies suggest that a routine invasive strategy reduces the risk of recurrent ischaemia and death or recurrent myocardial infarction over 5 years.1 In the RITA-3 trial, a routine invasive strategy was also associated with lower cardiovascular … ER -