Acute coronary syndromes
Conditions
Interventions
Against a background of optimized medical therapy patients are randomized between an early invasive strategy or a selective invasive strategy.
The early invasive strategy include angiography within 2
Sponsors
The ICTUS trial is supported by educational grants from Eli Lilly, Sanofi-Synthelabo, Aventis, Pfizer, and Medtronic.
Eligibility
Inclusion criteria
Inclusion criteria: 1. Symptoms of ischemia that were increasing or occurred at rest, with the last episode occurring no more than 24 hours before randomization; - an elevated cardiac troponin T level (≥0.03µg per liter); 2. and either ischemic changes as assessed by electrocardiography (defined as ST-segment depression or transient ST-segment elevation exceeding 0.05 mV, 3. or T-wave inversion of ≥0.2 mV in two contiguous leads) 4. or a documented history of coronary artery disease as evidenced by previous myocardial infarction, 5. findings on previous coronary angiography, or a positive exercise test.
Exclusion criteria
Exclusion criteria: 1. Age younger than 18 years or older than 80 years; 2. Myocardial infarction with ST-segment elevation in the past 48 hours; 3. An indication for primary percutaneous coronary intervention or fibrinolytic therapy, - hemodynamic instability or overt congestive heart failure; 4. The use of oral anticoagulant drugs in the past 7 days,; 5. Fibrinolytic treatment within the past 96 hours; 6. Percutaneous coronary intervention within the past 14 days; 7. A contraindication to treatment with percutaneous coronary intervention or glycoprotein IIb/IIIa inhibitors; 8. Recent trauma or risk of bleeding; 9. Hypertension despite treatment and weight greater than 120 kg.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary end point is 1. A composite of death; 2. Nonfatal myocardial infarction; 3. Or rehospitalization for anginal symptoms within one year after randomization. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. The occurrence of the components of the primary endpoint; 2. The occurrence of death or myocardial infarction; 3. A percutaneous coronary intervention; 4. Coronary artery bypass grafting; 5. Functional status after one, six, and twelve months; 6. Two, three and five years follow-up. | — |
Contacts
Public ContactR.J. Winter, de
Academic Medical Center (AMC), Department of Cardiology, B2-137, P.O. Box 22660
Outcome results
None listed