Summary of findings for the main comparison. Routine invasive strategies versus selective invasive strategies (conservative) for unstable angina and non‐ST elevation myocardial (UA/NSTEMI) infarction in the stent era.
| Routine invasive strategies versus selective invasive strategies (conservative) for UA/NSTEMI infarction in the stent era | |||||
| Participant or population: participants with UA/NSTEMI in the stent era Settings: hospital setting Intervention: routine invasive strategies Comparison: selective invasive strategies (conservative) | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | ||||
| Selective invasive strategies (conservative) | Routine invasive strategies | ||||
| Death Follow‐up: 6 to 12 months1 | Study population | RR 0.87 (0.64 to 1.18) | 8915 (8 studies) | ⊕⊕⊝⊝ low2,3 | |
| 42 per 1000 | 36 per 1000 (27 to 49) | ||||
| Moderate risk population | |||||
| 39 per 1000 | 34 per 1000 (25 to 46) | ||||
| Myocardial infarction Follow‐up: 6 to 12 months1 | Study population | RR 0.79 (0.63 to 1) | 8915 (8 studies) | ⊕⊕⊕⊝ moderate2 | |
| 78 per 1000 | 62 per 1000 (49 to 78) | ||||
| Moderate risk population | |||||
| 89 per 1000 | 70 per 1000 (56 to 89) | ||||
| Death or non‐fatal Myocardial infarction Follow‐up: 6 to 12 months1 | Study population | RR 0.93 (0.71 to 1.2) | 7715 (7 studies) | ⊕⊕⊝⊝ low2,3 | |
| 113 per 1000 | 105 per 1000 (80 to 135) | ||||
| Moderate risk population | |||||
| 109 per 1000 | 101 per 1000 (77 to 131) | ||||
| Refractory angina Follow‐up: 6 to 12 months1 | Study population | RR 0.64 (0.52 to 0.79) | 8287 (5 studies) | ⊕⊕⊕⊝ moderate2 | |
| 325 per 1000 | 208 per 1000 (169 to 257) | ||||
| Moderate risk population | |||||
| 129 per 1000 | 83 per 1000 (67 to 102) | ||||
| Rehospitalisation Follow‐up: 6 to 12 months1 | Study population | RR 0.77 (0.63 to 0.94) | 6921 (6 studies) | ⊕⊕⊕⊝ moderate2 | |
| 286 per 1000 | 220 per 1000 (180 to 269) | ||||
| Moderate risk population | |||||
| 122 per 1000 | 94 per 1000 (77 to 115) | ||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). Abbreviations: CI: confidence interval; RR: risk ratio; UA: unstable angina; NSTEMI: non ST segment myocardial infarction. | |||||
| GRADE Working Group grades of evidence High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | |||||
1 Intermediate end points. 2 Downgraded by one due to possible risk of bias due to lack of blinding. 3 Downgraded by one due to imprecision with effect size overlapping the line of no effect and appreciable benefit or harm.