Last year at the American Heart Association meeting, data from the TACTICS-TIMI*18 clinical trial showed the superiority of an early invasive strategy in patients with acute coronary syndromes (ACS) who had previously received medical therapy with aspirin, heparin, β-blockers and the glycoprotein IIb/IIIa receptor antagonist tirofiban ['Aggrastat'].1**Compared with a conservative strategy, the invasive strategy significantly reduced the risk of the composite endpoint of death, myocardial infarction (MI) and repeat hospitalisation with worsening chest pain, at 6 months. At the 50th Scientific Session of the American College of Cardiology [Orlando, US; March 2001], US cardiologist Dr William Weintraub presented the results of a prospective economic analysis of TACTICS-TIMI 18 which showed that the benefits of the invasive strategy were achieved with no appreciable increase in cost.2A related study showed that evaluation of patients with ACS using an assay for the cardiac enzyme troponin T can increase the proportion of patients who might benefit from invasive treatment.3