Hospital Patterns of Medical Management Strategy Use for Patients With Non–ST-Elevation Myocardial Infarction and 3-Vessel or Left Main Coronary Artery Disease

Ralf E. Harskamp, MD; Tracy Y. Wang, MD, MHS, MSc; Deepak L. Bhatt, MD, MPH; Stephen D. Wiviott, MD; Ezra A. Amsterdam, MD; Shuang Li, MS; Laine Thomas, PhD; Robbert J. de Winter, MD, PhD; Matthew T. Roe, MD, MHS


Am Heart J. 2014;167(3):355-362. 

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We found that approximately one-fifth of NSTEMI patients with 3VD/LMD identified during in-hospital angiography are treated with MMS without revascularization in contemporary practice. The use of MMS varies widely across U.S. hospitals with full revascularization capabilities, despite relatively similar hospital-level patient case-mix. Therefore, our findings indicate that there is no standard threshold for revascularization for NSTEMI patients with 3VD/LMD and that the decision-making process for revascularization procedures remains poorly understood.