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首页> 外文OA文献 >5-Year Clinical Outcomes in the ICTUS (Invasive versus Conservative Treatment in Unstable coronary Syndromes) Trial A Randomized Comparison of an Early Invasive Versus Selective Invasive Management in Patients With Non-ST-Elevation Acute Coronary Syndrome
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5-Year Clinical Outcomes in the ICTUS (Invasive versus Conservative Treatment in Unstable coronary Syndromes) Trial A Randomized Comparison of an Early Invasive Versus Selective Invasive Management in Patients With Non-ST-Elevation Acute Coronary Syndrome

机译：ICTUS的5年临床结果（不稳定冠状动脉综合征的有创与保守治疗）试验对非ST段抬高急性冠脉综合征的早期有创与选择性有创管理进行随机比较。

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OBJECTIVES: We present the 5-year clinical outcomes according to treatment strategy with additional risk stratification of the ICTUS (Invasive versus Conservative Treatment in Unstable coronary Syndromes) trial. BACKGROUND: Long-term outcomes may be relevant to decide treatment strategy for patients presenting with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) and elevated troponin T. METHODS: We randomly assigned 1,200 patients to an early invasive or selective invasive strategy. The outcomes were the composite of death or myocardial infarction (MI) and its individual components. Risk stratification was performed with the FRISC (Fast Revascularization in InStability in Coronary artery disease) risk score. RESULTS: At 5-year follow-up, revascularization rates were 81% in the early invasive and 60% in the selective invasive group. Cumulative death or MI rates were 22.3% and 18.1%, respectively (hazard ratio [HR]: 1.29, 95% confidence interval [CI]: 1.00 to 1.66, p = 0.053). No difference was observed in mortality (HR: 1.13, 95% CI: 0.80 to 1.60, p = 0.49) or MI (HR: 1.24, 95% CI: 0.90 to 1.70, p = 0.20). After risk stratification, no benefit of an early invasive strategy was observed in reducing death or spontaneous MI in any of the risk groups. CONCLUSIONS: In patients presenting with NSTE-ACS and elevated troponin T, we could not demonstrate a long-term benefit of an early invasive strategy in reducing death or MI. (Invasive versus Conservative Treatment in Unstable coronary Syndromes [ICTUS]; ISRCTN82153174)
机译：目的：根据治疗策略，结合ICTUS（不稳定冠状动脉综合征的介入治疗与保守治疗）试验的其他风险分层，我们介绍了5年临床结果。背景：长期结果可能与决定非ST段抬高的急性冠状动脉综合征（NSTE-ACS）和肌钙蛋白T升高的患者的治疗策略有关。方法：我们将1200例患者随机分为早期侵入性或选择性侵入性战略。结果是死亡或心肌梗塞（MI）及其各个组成部分的综合。风险分层采用FRISC（冠状动脉疾病不稳定中的快速血运重建）风险评分进行。结果：在5年的随访中，早期浸润组的血运重建率为81％，选择性浸润组的血运重建率为60％。累积死亡或心梗率分别为22.3％和18.1％（危险比[HR]：1.29，95％置信区间[CI]：1.00至1.66，p = 0.053）。死亡率（HR：1.13，95％CI：0.80至1.60，p = 0.49）或MI（HR：1.24，95％CI：0.90至1.70，p = 0.20）没有观察到差异。风险分层后，在任何风险组中，均未观察到早期侵入性策略可减少死亡或自发性MI的益处。结论：在患有NSTE-ACS和肌钙蛋白T升高的患者中，我们无法证明早期侵入性策略可减少死亡或心肌梗塞的长期获益。 （不稳定型冠状动脉综合征[ICTUS]的侵入性和保守性治疗； ISRCTN82153174）

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