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Risk Level Affects Coronary Syndrome Treatment in Women

Invasive strategy is effective in reducing risk among men and high-risk women with acute coronary syndrome

TUESDAY, July 1 (HealthDay News) -- In men and high-risk women with non-ST-segment elevation acute coronary syndromes (NSTE ACS), an invasive strategy has a comparable benefit for reducing the odds of myocardial infarction, rehospitalization with acute coronary syndrome or death, although a conservative strategy seems to be more effective for low-risk women, according to study findings published in the July 2 issue of the Journal of the American Medical Association.

Michelle O'Donoghue, M.D., of Brigham and Women's Hospital in Boston, and colleagues performed a meta-analysis of eight trials involving 3,075 women and 7,075 men, to compare the effects of invasive and conservative strategies in men and women with NSTE ACS. The trials took place between 1970 and April 2008.

The researchers found that, for invasive versus conservative strategy, the odds ratio for the composite of death, myocardial infarction or acute coronary syndrome was 0.81 in women and 0.73 in men. An invasive strategy was associated with a 33 percent lower odds of death, myocardial infarction or acute coronary syndrome in biomarker-positive women, the investigators note. However, among biomarker-negative women, an invasive strategy was not associated with a significant reduction in the triple composite end point (odds ratio, 0.94). In men, the odds ratio for death, myocardial infarction or acute coronary syndrome was 0.56 if biomarker-positive and 0.72 if biomarker-negative.

"Our data provide evidence to support the updated American College of Cardiology/American Heart Association guidelines that now recommend that a conservative strategy be used in low-risk women with NSTE ACS," the authors write.

The study authors have disclosed financial ties to several pharmaceutical companies.

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