Early or Delayed Intervention for Acute Coronary Syndromes Without ST-Segment-Elevation?

In a randomized trial, only high-risk patients clearly benefited from invasive treatment within 24 hours.

Although routine invasive treatment of acute coronary syndromes without ST-segment-elevation is associated with improved outcomes, the optimal timing of such interventions is unclear. To compare outcomes of early versus delayed coronary angiography and revascularization, investigators from the Timing of Intervention in Acute Coronary Syndromes (TIMACS) study assigned 3031 adults with non–ST-segment-elevation ACS (mean age, 65; women, 35%) to receive such treatment either within 24 hours of symptom onset or more than 36 hours afterward. All patients also had at least two of the following risk factors: age ≥60, elevated cardiac biomarkers, or electrocardiographic signs of ischemia.

At 6 months, the primary outcome — a composite of death, MI, a…

Reviewing Author

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)