Outcome Analysis of one year after an Invasive Compared with Non-Invasive Strategy in Unstable Angina

Background: In those patients with acute coronary syndrome who have NSTEMI or unstable angina, two kind of treatment have been generally offered, either a routine invasive strategy shortly after admission, where all patients undergo coronary angiography and revascularization where needed, or a conservative strategy where only medicines are used. Aim: To compare clinical outcomes of patients with unstable angina after one year, in invasive and non-invasive treatment modalities. Study Design: Cohort study design. Setting & duration: Department of Cardiology, Mayo Hospital Lahore., One year (from 3-2-2017 to 3-2-2018). Methods: 74 patients fulfilling selection criteria were enrolled. The patients were divided into two groups. In group A, patients were treated with invasive approach along with medication. In group B, patients were treated with medication only. Both group patients were followed-up for one year and were evaluated for survival and other outcomes. Results: Our study shows more patients survived in the group A where interventional procedure (Coronary Angiography,followed by PCI OR CABG etc) was carried out as compared to noninvasive group where only medication were used. Mean age of study population was 52.25 (invasive: 51.59 +/- 9.03 years while non-invasive: 52.92 +/- 10.37 years). There were 28(75.7%) males and 9(24.3%) females in invasive group. There were 23(62.2%) males and 14(37.8%) females in non-invasive group. There were 35(94.6%) patients who survived in invasive group while 31 (83.8%) patients survived in non-invasive group (p-value = 0.134). Almost similar results were seen for other outcomes. 11(29.7%) patients had readmission in invasive group while 13(35.1%) patients had readmission in non-invasive group (p = 0.619). Conclusion: The difference of mortality and other outcomes was not statistically significant in both groups (p>0.05), although the number of patients with survival and better outcomes were more in invasive group as compared to conservative group.