Routine Primary PCI;Whether and When Necessary for the Management of NSTEMI—An Evidence Based Evaluation

Non ST elevated myocardial infarction (NSTEMI) accounts for a significant portion of the hospitalizations due to acute coronary syndromes worldwide and is posing a huge challenge towards the health care cost globally. This signifies the need for proper triage and management stratification for the best utilization of the health care resources. Primary Percutaneous Coronary Intervention (PCI) with early revascularization is a new emerging invasive technique and application of this technique is increasing tediously among the clinicians. However, the current body of evidences is divided between the efficacy, need and critical timing of PCI compared to conservative management in the treatment protocol for NSTEMI. A review of trials done comparing the early use of PCI versus conservative management indicates inconsistent finding with strong evidence towards early use of PCI in moderate to high-risk NSTEMI patients.