To perform an updated systematic review comparing a routine invasive strategy with a selective invasive strategy for patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) in the era of stents and antiplatelet therapy.Recent meta-analyses comparing both strategies have shown conflicting results.Electronic databases were searched for randomized trials that compared a routine invasive strategy (i.e., routine coronary angiography +/- revascularization) versus a selective invasive strategy (i.e., medical stabilization and coronary angiography +/- revascularization if objective evidence of ischemia or refractory ischemia) in patients with NSTE-ACS. Summary odds ratios (OR) were primarily constructed using Peto's model.Twelve trials with 9,650 patients were included. Compared with a selective invasive strategy, a routine invasive strategy was associated with a reduction in the composite of all-cause mortality or myocardial infarction (MI) [OR: 0.86, 95

作者：Islam Y, Elgendy；Dharam J, Kumbhani；Ahmed N, Mahmoud；Xuerong, Wen；Deepak L, Bhatt；Anthony A, Bavry

来源：Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2016 年 88卷 5期