Delayed Intervention (ABOARD) trial was designed to

mc.duke.edu ABOARD randomised controlled trial No difference in peak troponin level in immediate versus delayed (next working day) intervention for acute coronary syndrome without ST-segment elevation Patients with high-risk acute coronary syndromes have been shown to benefi t from a strategy of early invasive catheterisation, and this is refl ected in the US and European guidelines. However, the recently reported long-term fol-low-up from the Invasive versus Conservative Treatment in Unstable Coronary Syndromes (ICTUS) trial shows that even patients with elevated troponin may not benefi t sub-stantially from an early invasive strategy, compared with a “selective invasive ” strategy, in the context of optimum medical therapy.1 Selected trials have suggested benefi ts from very early routine catheterisation,2 3 particularly among high-risk patients,3 although it remains unclear whether immediate catheterisation and revascularisation has measurable benefi ts compared with the more conve-nient approach of catheterisation the next working day