Mini Journal Club: Invasive Therapy for ACS

Sign in or subscribe to listen

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Jeremiah Y., MD -

Readmission may not be equal to death, but if all end points are the same wouldn't you want one that avoids repeat admission?

David H Newman -

Good question!

Problem is that the endpoint is subjective (disposition, as EPs know, is entirely dependent upon who the doc is), so the endpoint is biased - i.e. it's not clear that the lower admission rate was due to the therapy.

But, presuming it is not an unreliable endpoint: Great! Invasive therapy reduces admissions by 5% (1 in 20). Would we want everyone to have an invasive procedure that costs about $15K and includes a 1/200 risk of major end organ damage, and a 1 in 10 chance of bleeding or other minor complication, just so that 1 in 20 people could avoid a later admission?

Doing invasive, dangerous, expensive therapies in everyone in order to avoid a hospital admission for 1 in 20 would be a strange trade-off.

Hope that answers the question.

Mazdak M., Dr -

Just wondering to know , what was the time frame for early invasive therapy ??

To join the conversation, you need to subscribe.

Sign up today for full access to all episodes and to join the conversation.