Editorial
Invasive coronary revascularisation is better than conservative treatment in patients with acute coronary syndromes
| The first 150 words of the full text of this article appear below. |
New advances in interventional cardiology and antithrombotic pharmacological treatment have modified the risk:benefit ratio of percutaneous interventions in acute coronary syndromes without ST segment elevation.
In general terms, invasive strategies have two main limitations. The
first stems from the fact that the severity of a coronary stenosis is
not an index of the likelihood of the development of clinical
instability or future cardiovascular events.1 It is now
well known that the main pathophysiological mechanism of acute coronary
syndromes is destabilisation of the atherosclerotic plaque, which leads
to fissuring and the consequent exposure of the subendothelium matrix.
The critical factors determining the clinical manifestations and
prognosis of these syndromes are the duration and degree of the
reduction in coronary flow caused by thrombosis (and its variable
associations with superimposed vasoconstriction), the coexistence of
collateral flows, and the microvascular embolisation of platelet
aggregates and atherothrombotic material. Given the lack of suitable
instruments
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