Acute Coronary Syndrome Clinical Trial
Official title:
Randomized Comparison Between Invasive and Conservative Strategies in Patients With Non-ST-segment Elevation Acute Coronary Syndrome and Comorbidities
The guidelines of clinical practice, based on the randomized studies, recommend an invasive
strategy in non-ST elevation acute coronary syndrome (NSTEACS). However, patients with
comorbidities are excluded from the randomized studies and the observational registries
showthat patients with comoribidities undergo fewer cardiac catheterizations. The aim is to
investigate the benefit of the invasive strategy in patients with NSTEACS and comorbidities.
Patients hospitalized with NSTEACS, older than 70 years and with significant comorbidities,
will be included. The latter will be defined as at least 2 of the following: peripheral
artery disease, cerebral vascular disease, dementia, chronic pulmonary disease, chronic
renal failure and anemia. The included patients will be randomized to an invasive (routine
coronary angiogram) or conservative (coronary angiogram only if recurrent or inducible
ischemia) strategy. All patients will receive medical treatment according to current
recommendations.
The main outcome will be death, reinfarction or readmissions by heart cause at one-year
follow-up. The hypothesis is that an invasive strategy will improve prognosis in patients
with NSTEACS and comorbidities.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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