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European Heart Journal Advance Access originally published online on November 30, 2004
European Heart Journal 2005 26(2):201; doi:10.1093/eurheartj/ehi048
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European Heart Journal vol. 26 no. 2 © The European Society of Cardiology 2004; all rights reserved.

 

Revascularization for everyone?: reply

Christopher P. Cannon

Brigham and Women's Hospital
TIMI Study
350 Longwood Avenue
1st floor, Boston,
MA 02115, USA
Tel.: +1 617 278 0146
Fax: +1 617 734 7329
E-mail address: cpcannon{at}partners.org

I agree with Dr Rott that all patients with unstable angina or non-ST elevation myocardial infarction should undergo risk stratification. Patients at higher risk will benefit from an early invasive strategy, and patients at low risk can be equally well managed with an early invasive or early conservative strategy.1,2 The latter would include cardiac catheterization and revascularization for patients who develop recurrent ischaemia at rest, or who have evidence of provokeable ischaemia on stress testing.

(Note, with regard to ICTUS, my editorial was published on 23 July 2004, one month before this trial was presented, thus I was not able to include it.)

References

  1. Cannon CP, Weintraub WS, Demopoulos LA, Vicari R, Frey MJ, Lakkis N, Neumann F-J, Robertson DH, DeLucca PT, DiBattiste PM, Gibson CH, Braunwald E. 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 2001;344:1879–1887.[Abstract/Free Full Text]
  2. Cannon CP. Evidence-based risk stratification to target therapies in acute coronary syndromes. Circulation 2002;106:1588–1591.[Free Full Text]

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This Article
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ehi048v1
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