PMID- 16152646
OWN - NLM
STAT- MEDLINE
DCOM- 20060316
LR  - 20191210
IS  - 1522-1946 (Print)
IS  - 1522-1946 (Linking)
VI  - 66
IP  - 2
DP  - 2005 Oct
TI  - Utilization of catheterization and revascularization procedures in patients with 
      non-ST segment elevation acute coronary syndrome over the last decade.
PG  - 149-57
AB  - The degree to which catheterization and revascularization procedures are utilized 
      in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) 
      during hospitalization has broad implications with respect to initial 
      pharmacotherapeutic decisions (upfront therapies), treatment and hospital 
      transfer protocols, guideline recommendations, and allocation of training, 
      material, and financial resources. Analysis of data from multiple trials and 
      registries of patients with NSTE-ACS has the potential to assess more broadly 
      utilization of invasive and revascularization procedures and provide a wide angle 
      or bird's-eye view of the management of such patients, complementing the data 
      obtained from any one trial or registry. We therefore undertook a systematic 
      overview of all large trials and registries of patients with NSTE-ACS conducted 
      over the last decade that were deemed appropriate to provide information on 
      catheterization and revascularization procedures. Although not unexpectedly the 
      percentage of patients with NSTE-ACS managed with cardiac catheterization, 
      percutaneous coronary intervention (PCI), and coronary artery bypass grafting 
      varies in different clinical trials and registries, general findings and trends 
      were still discernable from these studies. During the initial treatment period, 
      the majority of patients were ultimately treated with medical therapy alone 
      (e.g., without revascularization). The percentage of those NSTE-ACS patients 
      undergoing diagnostic cardiac catheterization who were then managed with PCI 
      increased over the last decade and now stands at approximately 50%. Of NSTE-ACS 
      patients who undergo revascularization, the percentage of those patients who are 
      revascularized via PCI similarly increased, and PCI is currently the 
      revascularization procedure utilized in approximately three-fourths of patients 
      undergoing revascularization. The percentages of patients undergoing invasive and 
      revascularization procedures were consistently higher in the U.S. cohorts of 
      study subjects when compared to non-U.S. cohorts of study subjects.
FAU - Levine, Glenn N
AU  - Levine GN
AD  - Baylor College of Medicine and the Houston VA Medical Center, Houston, Texas 
      77030, USA. glevine@bcm.tmc.edu
FAU - Lincoff, A Michael
AU  - Lincoff AM
FAU - Ferguson, James J 3rd
AU  - Ferguson JJ 3rd
FAU - Mahaffey, Kenneth W
AU  - Mahaffey KW
FAU - Goodman, Shaun G
AU  - Goodman SG
FAU - Cannon, Christopher P
AU  - Cannon CP
FAU - Theroux, Pierre
AU  - Theroux P
FAU - Fox, Keith A A
AU  - Fox KA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
SB  - IM
MH  - Acute Disease
MH  - Angina, Unstable/*therapy
MH  - Cardiac Catheterization/methods/*statistics & numerical data/trends
MH  - Humans
MH  - Myocardial Infarction/*therapy
MH  - Myocardial Revascularization/methods/*statistics & numerical data/trends
MH  - *Outcome Assessment, Health Care
MH  - Randomized Controlled Trials as Topic
MH  - Registries
EDAT- 2005/09/10 09:00
MHDA- 2006/03/17 09:00
CRDT- 2005/09/10 09:00
PHST- 2005/09/10 09:00 [pubmed]
PHST- 2006/03/17 09:00 [medline]
PHST- 2005/09/10 09:00 [entrez]
AID - 10.1002/ccd.20469 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2005 Oct;66(2):149-57. doi: 10.1002/ccd.20469.