This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Joel M. Gore, MD; James E. Dalen, MD

JAMA. 1995;273(21):1662-1664.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The most common cardiovascular causes of hospital admission in the United States are unstable angina and non—Q-wave myocardial infarction. The efficacy of thrombolytic therapy in patients with these disorders is unclear, and the role of routine early coronary arteriography followed by revascularization is uncertain. The Thrombolysis in Myocardial Ischemia trial randomized 1473 patients with unstable angina or non—Q-wave myocardial infarction in a 2x2 factorial design comparing (1) tissue-type plasminogen activator vs placebo and (2) an early invasive strategy vs an early conservative strategy.¹ The investigators found that thrombolytic therapy was not beneficial and may be harmful. With respect to early coronary arteriography, there was no difference in mortality or recurrent myocardial infarction at 6 weeks. There was, however, a reduction in days of hospitalization and rehospitalization and in the use of antianginal drugs.

The current approach to the treatment of patients with acute coronary syndromes is to administer intravenous . . . [Full Text PDF of this Article]

Author Affiliations
University of Massachusetts Medical School, Worcester; The University of Arizona Health Sciences Center, Tucson

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?