American Heart Journal
Volume 156, Issue 5 , Pages 946-953.e2 , November 2008

Patterns of use and effectiveness of early invasive strategy in non–ST-segment elevation acute coronary syndromes: An assessment by propensity score

  • Ignacio Ferreira-González, MD

      Affiliations

    • Vall d'Hebron Hospital, Barcelona, Spain
    • CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
    • ,
  • Gaietà Permanyer-Miralda, MD

      Affiliations

    • Vall d'Hebron Hospital, Barcelona, Spain
    • CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
    • Corresponding Author InformationReprint requests: Gaietà Permanyer-Miralda, MD, Cardiology Department, Epidemiology Unit, Vall d'Hebron Hospital, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain.
    • ,
  • Magda Heras, MD

      Affiliations

    • Hospital Clinic, Barcelona, Spain
    • ,
  • José Cuňat, MD

      Affiliations

    • Hospital Clínico, Valencia, Spain
    • ,
  • Emilia Civeira, MD

      Affiliations

    • Hospital Clínico, Zaragoza, Spain
    • ,
  • Fernando Arós, MD

      Affiliations

    • Hospital de Txagorritxu, Vitoria, Spain
    • ,
  • Juan J. Rodríguez, MD

      Affiliations

    • Hospital Carlos Haya, Málaga, Spain
    • ,
  • Pedro L. Sánchez, MD

      Affiliations

    • Hospital General Universitario “Gregorio Marañón”, Madrid, Spain
    • ,
  • Josep R. Marsal, BSc

      Affiliations

    • Vall d'Hebron Hospital, Barcelona, Spain
    • CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
    • ,
  • Aida Ribera, BSc, PhD

      Affiliations

    • Vall d'Hebron Hospital, Barcelona, Spain
    • CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
    • ,
  • Jaume Marrugat, MD

      Affiliations

    • Institut Municipal d'Investigació Mèdica (IMIM, Hospital del Mar), Barcelona, Spain
    • ,
  • Héctor Bueno, MD

      Affiliations

    • Hospital General Universitario “Gregorio Marañón”, Madrid, Spain
    • ,
  • for the MASCARA study group

      Affiliations

    • A full list of MASCARA study group members is available in Appendix B available online.

Received 13 February 2008 ,Accepted 26 June 2008.

References 

  1. Lopez BL, Aros BF, Lidon RM, et al. 2002 Update of the guidelines of the Spanish Society of Cardiology for unstable angina/without ST-segment elevation myocardial infarction. Rev Esp Cardiol. 2002;55:631–642
  2. Hirsch A, Windhausen F, Tijssen JG, et al. 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;369:827–835
  3. Bassand JP, Hamm CW, Ardissino D, et al. Guidelines for the diagnosis and treatment of non–ST-segment elevation acute coronary syndromes. The Task Force for the Diagnosis and Treatment of Non–ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology. Eur Heart J. 2007;28:1598–1660
  4. Permanyer-Miralda G, Ferreira-Gonzalez I, Marrugat J, et al. Rationale and conceptual design of MASCARA study: a challenge in the evaluation of the effectiveness. Med Clin (Barc). 2005;125:580–584
  5. Ferreira-Gonzalez I, Permanyer-Miralda G, Marrugat J, et al. MASCARA (Manejo del Síndrome Coronario Agudo. Registro Actualizado) study. Overall results. Rev Esp Cardiol. 2008;(in press)
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  12. Bhatt DL, Roe MT, Peterson ED, et al. Utilization of early invasive management strategies for high-risk patients with non–ST-segment elevation acute coronary syndromes: results from the CRUSADE Quality Improvement Initiative. JAMA. 2004;292:2096–2104
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  15. Wallentin L, Lagerqvist B, Husted S, et al. Outcome at 1 year after an invasive compared with a non-invasive strategy in unstable coronary-artery disease: the FRISC II invasive randomised trial. FRISC II Investigators. Fast Revascularisation during Instability in Coronary artery disease. Lancet. 2000;356:9–16
  16. Mehta SR, Cannon CP, Fox KA, et al. Routine vs selective invasive strategies in patients with acute coronary syndromes: a collaborative meta-analysis of randomized trials. JAMA. 2005;293:2908–2917
  17. Van de Werf F, Gore JM, Avezum A, et al. Access to catheterisation facilities in patients admitted with acute coronary syndrome: multinational registry study. BMJ. 2005;330:441
  18. Cannon CP, Weintraub WS, Demopoulos LA, et al. Compari son 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

 The authors of this article have no conflicts of interest to declare.

 The present study has been funded with grants from the Fondo de Investigación Sanitaria (PI04/1408) and Red de Investigación Cardiovascular del Instituto Carlos III (RECAVA), and from an unrestricted grant of Bristol-Myers-Squibb.

PII: S0002-8703(08)00554-1

doi: 10.1016/j.ahj.2008.06.032

American Heart Journal
Volume 156, Issue 5 , Pages 946-953.e2 , November 2008

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