Early revascularisation of no benefit in mild heart attacks

BMJ 1998; 316 doi: (Published 27 June 1998) Cite this as: BMJ 1998;316:1928
  1. Deborah Josefson
  1. San Francisco

    Conservative treatment for mild heart attacks is superior to early revascularisation, according to an American trial.

    More than 900 patients, mostly men, with non-Q wave infarctions were enrolled in the study and randomly assigned either to invasive or to conservative management (New England Journal of Medicine 1998;338:1785-92). The invasive group underwent coronary angiography followed by either balloon angioplasty or a bypass procedure.

    Conservative management consisted of non-invasive testing, medical treatment, and thrombolytics, if necessary. Patients randomised to conservative management who had recurrent ischaemia within 72 hours after their initial heart attack were able to switch to aggressive treatment. Both groups received aspirin and diltiazem.

    The investigators found no clear …

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