5-year outcomes in the FRISC-II randomised trial of an invasive versus a non-invasive strategy in non-ST-elevation acute coronary syndrome: a follow-up study  

Oleh:

Lagerqvist, Bo ; Husted, Steen ; Kontny, Fredrik ; Stahle, Elisabeth ; Swahn, Eva

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Lancet (keterangan: ada di Proquest) vol. 368 no. 9540 (Sep. 2006), page 998.

Ketersediaan

Perpustakaan FK Nomor Panggil: L01.K.2006.05 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background The FRISC-II invasive trial compared an early invasive with a non-invasive strategy in terms of death and myocardial infarction in non-ST-elevation acute coronary syndrome. We present 5-year follow-up results, overall and in subgroups based on recommended risk stratification criteria. Methods In the FRISC-II trial, 2457 patients with non-ST-elevation acute coronary syndrome were randomised to early invasive strategy (coronary angiography and, if appropriate, revascularisation, within 7 days from admission) or non-invasive primarily medical strategy. Risk stratification was done on the basis of risk indicators at randomisation: age older than 65 years, male sex, diabetes mellitus, previous myocardial infarction, ST-segment depression, raised troponin concentration (>0·03 µg/L), and raised C-reactive protein or interleukin 6. Information on events after 24 months was taken from national registries. Analyses were done on an intention-to-treat basis. Findings At 5 years the groups differed in terms of the primary composite endpoint of death, myocardial infarction, or both (invasive 217, 19·9 %; noninvasive 270, 24·5 %; risk ratio 0·81; 95% CI 0·69—0·95; p=0·009). 5-year mortality was 117 (9·7%) in the invasive group compared with 124 (10·1%) in the noninvasive group (0·95; 0·75 -1·21; p=0·693). Rates of myocardial infarction were 141 (12·9 %) in the invasive and 195 (17.7%) in the non-invasive group (0·73; 0·60—0·89; p=0·002). The benefit of the invasive strategy was confined to male patients, non-smokers, and patients with two or more risk indicators. Interpretation The 5-year outcome of this trial indicates sustained benefit of an early invasive strategy in patients with non-ST-elevation acute coronary syndrome at moderate to high risk.

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