Abstract
Abstract Background: The aim of this study was to compare an early versus a delayed invasive strategy in NSTE-ACS prospectively. Methods: Prospective observational study including patients admitted for NSTE-ACS requiring an invasive management. The primary endpoint was the occurrence of MACCE (death, new myocardial infarction or stroke) at 30-days and 1-year follow-up. Results: 167 patients in the early-intervention group (within 24 hours, n = 167) and 129 patients in the delayed-intervention group (24 to 72 hours, n = 129). There was no difference in the primary endpoint of 30-days MACCE (4.2% vs. 6.2%; p = 0.25) and 1-year MACCE (10.2% vs. 17.1%; p = 0.34). Conclusions: An early invasive strategy does not reduce the risk of death or MACCE compared with a delayed strategy.
Highlights
In patients with myocardial infarction with ST-segment elevation, in which the infarct-related artery is usually occluded and there is ongoing transmural ischemia, it is well established that the earlier primary percutaneous coronary intervention (PCI) can be performed, the lower the mortality [1,2]
In patients with acute coronary syndromes without ST-segment elevation, the culprit artery is often patent, there is usually no ongoing transmural ischemia, and the patient often has a good response to initial medical treatment [3]
Observational study to determine the impact of timing of invasive strategy in the clinical outcome of patients with NSTE-ACS
Summary
In patients with myocardial infarction with ST-segment elevation, in which the infarct-related artery is usually occluded and there is ongoing transmural ischemia, it is well established that the earlier primary percutaneous coronary intervention (PCI) can be performed, the lower the mortality [1,2]. In patients with acute coronary syndromes without ST-segment elevation (including unstable angina and myocardial infarction), the culprit artery is often patent, there is usually no ongoing transmural ischemia, and the patient often has a good response to initial medical treatment [3]. Intervention might prevent ischemic events that could occur while the patient is awaiting a delayed procedure [5]. The aim of this study was to compare an early versus a delayed invasive strategy in NSTE-ACS prospectively
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