Jun Zhang1, Shu-bin Qiao, Jun Zhu. 1. Chinese Academy of Medical Sciences, Beijing 100037, China. zhangjun-cv@263.net
Abstract
OBJECTIVE: To compare the effect and safety of early intervention and delayed intervention in patients with non-ST segment elevation acute coronary syndrome. METHODS: In this multicenter randomized trial, patients diagnosed as non-ST segment elevation acute coronary syndrome were randomly assigned to undergo early intervention (coronary angiography ≤ 24 hours after randomization, n = 446) or delayed intervention (coronary angiography ≥ 36 hours after randomization, n = 369). The primary outcome was a composite of death, myocardial infarction or stroke at 180 days. The secondary outcome was death, myocardial infarction, refractory ischemia, stroke or revascularization at 180 days. RESULTS: Baseline clinical characteristics were comparable between the two groups. Incidence of both primary (9.0% vs. 14.6%, P = 0.01) and secondary which was a composite of death, myocardial infarction or refractory ischemia (14.6% vs. 22.0% P = 0.01) endpoints were significantly lower in early intervention group than in delayed intervention group. Incidence of myocardial infarction was significantly lower in early intervention group than in delayed intervention group (5.2% vs. 10.8%, P = 0.00). Another secondary outcome which was a composite of death, myocardial infarction, refractory ischemia, stroke or revascularization was similar between the two groups (26.7% vs. 30.4%, P = 0.25). CONCLUSION: Compared to delayed intervention group, early intervention reduced incidence of myocardial infarction but did not affect the incidence of death, stroke or refractory ischemia in patients with non-ST segment elevation acute coronary syndrome.
RCT Entities:
OBJECTIVE: To compare the effect and safety of early intervention and delayed intervention in patients with non-ST segment elevation acute coronary syndrome. METHODS: In this multicenter randomized trial, patients diagnosed as non-ST segment elevation acute coronary syndrome were randomly assigned to undergo early intervention (coronary angiography ≤ 24 hours after randomization, n = 446) or delayed intervention (coronary angiography ≥ 36 hours after randomization, n = 369). The primary outcome was a composite of death, myocardial infarction or stroke at 180 days. The secondary outcome was death, myocardial infarction, refractory ischemia, stroke or revascularization at 180 days. RESULTS: Baseline clinical characteristics were comparable between the two groups. Incidence of both primary (9.0% vs. 14.6%, P = 0.01) and secondary which was a composite of death, myocardial infarction or refractory ischemia (14.6% vs. 22.0% P = 0.01) endpoints were significantly lower in early intervention group than in delayed intervention group. Incidence of myocardial infarction was significantly lower in early intervention group than in delayed intervention group (5.2% vs. 10.8%, P = 0.00). Another secondary outcome which was a composite of death, myocardial infarction, refractory ischemia, stroke or revascularization was similar between the two groups (26.7% vs. 30.4%, P = 0.25). CONCLUSION: Compared to delayed intervention group, early intervention reduced incidence of myocardial infarction but did not affect the incidence of death, stroke or refractory ischemia in patients with non-ST segment elevation acute coronary syndrome.
Authors: Eliano P Navarese; Bernhard Wernly; Michael Lichtenauer; Martino Pepe; Wojciech Wanha; Giuseppe Ferrante; Lara Frediani; Verena Veulemans; Tobias Zeus; Ralf Westenfeld; Christian Jung; Paul A Gurbel Journal: J Thorac Dis Date: 2018-01 Impact factor: 2.895
Authors: Thomas A Kite; Sameer A Kurmani; Vasiliki Bountziouka; Nicola J Cooper; Selina T Lock; Chris P Gale; Marcus Flather; Nick Curzen; Adrian P Banning; Gerry P McCann; Andrew Ladwiniec Journal: Eur Heart J Date: 2022-09-01 Impact factor: 35.855