Early-invasive or early-conservative management of patients with unstable angina or non-Q-wave myocardial infarction

The optimal therapy for non-ST-segment-elevation acute coronary syndromes i s the subject of considerable debate: is early catheterization and revascul arization (early-invasive strategy) or continued medical therapy unless sym ptoms are refractory (early-conservative strategy) best! Although several c linical trials have sought to answer this question, the methodologies they employed have been widely criticized, and no consensus has been reached. Th e new antiplatelet therapies have proved beneficial for primary medical man agement and as adjuncts to percutaneous interventions. It is not yet clear, however, whether use of these therapies will preferentially benefit one of the treatment strategies.