Invasive Strategies in Non–ST-Segment-Elevation Acute Coronary Syndromes: How Early Is Early Enough?

A retrospective analysis of ACUITY trial data suggests that waiting more than a day can adversely affect outcomes.

An early invasive strategy improves outcomes in patients with non–ST-segment-elevation acute coronary syndromes (NSTEACS), but precisely how soon catheterization should occur after presentation has not been well studied. In this study of ACUITY trial data, investigators stratified 7749 NSTEACS patients who underwent percutaneous coronary intervention (PCI) into tertiles based on time from presentation to revascularization (<8 hours, 8–24 hours, ≥24 hours).

At 30 days and at 1 year, mortality and the composite rate of death and myocardial infarction (MI) were similar in patients who had PCI <8 hours after presentation and in those who had PCI 8 to 24 hours after presentation. However, in patients undergoing PCI ≥24 hours after presentation, t…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI