Noninvasive, medical management for non-ST-elevation acute coronary syndromes.


Journal Article (Review)

Despite emphasis on the use of invasive management strategies for patients with non-ST-elevation acute coronary syndromes (NSTE ACS) in recent practice guidelines, 27% to 56% of NSTE ACS patients do not undergo diagnostic angiography, and a further 45% to 78% do not undergo revascularization procedures during the initial hospitalization. These medically managed patients (also termed noninvasive management) have a greater frequency of medical comorbidities and high-risk clinical characteristics and are less likely to receive guideline-recommended medications, compared with patients who undergo revascularization procedures. The rates of short and long-term adverse outcomes are also substantially higher in medically managed NSTE ACS patients, but more widespread implementation of contemporary medical therapies in this population is limited by exclusion of medically managed patients from many randomized clinical trials.

Full Text

Duke Authors

Cited Authors

  • Chan, MY; Becker, RC; Harrington, RA; Peterson, ED; Armstrong, PW; White, H; Fox, KAA; Ohman, EM; Roe, MT

Published Date

  • March 2008

Published In

Volume / Issue

  • 155 / 3

Start / End Page

  • 397 - 407

PubMed ID

  • 18294472

Pubmed Central ID

  • 18294472

Electronic International Standard Serial Number (EISSN)

  • 1097-6744

Digital Object Identifier (DOI)

  • 10.1016/j.ahj.2007.11.014


  • eng

Conference Location

  • United States