Early invasive therapy of non ST-elevation acute coronary syndromes--combined with upstream antiplatelet therapy: yes--but how early?

See doi:10.1016/S1095-668X(03)00259-8for the article to whichthis editorial refers The increasing number of patients with non ST-elevation acutecoronary syndromes (ACS) is placing an enormous economic burdenon health care in Western countries. Recently updated Europeanand American guidelines have clarified the recommendations forhow these patients should be treated.^1,2The well-conducted FRISCII trial strongly suggested the superiority of early invasivestrategy compared to a more watchful ‘wait-and-see’conservative strategy.³These observations were further confirmedby the TACTICS–TIMI 18 trial,⁴where early invasive strategywith an adjunctive upstream glycoprotein (GP) 2b/3a inhibitorfrom 4 to 48h (median 22h) before the intervention appearedto result in