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10.1038/srep27345

http://scihub22266oqcxt.onion/10.1038/srep27345
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C4895177!4895177!27273697
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suck abstract from ncbi


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pmid27273697      Sci+Rep 2016 ; 6 (ä): ä
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  • Early Invasive Strategy for Unstable Angina: a New Meta-Analysis of Old Clinical Trials #MMPMID27273697
  • Manfrini O; Ricci B; Dormi A; Puddu PE; Cenko E; Bugiardini R
  • Sci Rep 2016[]; 6 (ä): ä PMID27273697show ga
  • Randomized controlled trials (RCTs) were conflicting to support whether unstable angina versus non-ST-elevation myocardial infarction (UA/NSTEMI) patients best undergo early invasive or a conservative revascularization strategy. RCTs with cardiac biomarkers, in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from 1975?2013 were reviewed considering all cause mortality, recurrent non-fatal myocardial infarction (MI) and their combination. Follow-up lasted from 6?24 months and the use of routine invasive strategy up to its end was associated with a significantly lower composite of all-cause mortality and recurrent non-fatal MI (Relative Risk [RR] 0.79; 95% confidence interval [CI], 0.70?0.90) in UA/NSTEMI. In NSTEMI, by the invasive strategy, there was no benefit (RR 1.19; 95%?CI, 1.03?1.38). In the shorter time period, from randomization to discharge, a routine invasive strategy was associated with significantly higher odds of the combined end-point among UA/NSTEMI (RR 1.29; 95%?CI, 1.05?1.58) and NSTEMI (RR 1.82; 95%?CI, 1.34?2.48) patients. Therefore, in trials recruiting a large number of UA patients, by routine invasive strategy the largest benefit was seen, whereas in NSTEMI patients death and non-fatal MI were not lowered. Routine invasive treatment in UA patients is accordingly supported by the present study.
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