Summary: Patients with unstable angina and non-ST elevation myocardial infarction (NSTEMI) were randomized to early invasive versus initial conservative strategies. The early invasive strategy reduced the primary endpoint of composite death, nonfatal MI and rehospitalization for an acute coronary syndrome only in the patients that were troponin positive. The troponin negative patients did not receive benefit from an early invasive strategy. When the TIMI risk score was utilized, those with a score > 3 had the most benefit from an early invasive strategy. If the TIMI risk score was < 2, then there was no difference between early invasive and initial conservative management in terms of the primary endpoint.

Original Publication:

N Engl J Med. 2001 Jun 21;344(25):1879-87.

Eponym: Treat Angina with Aggrastat and Determine the Cost of Therapy With Invasive or Conservative Strategy - Thrombolysis In Myocardial Infarction