Early invasive strategy for non-ST elevation acute coronary syndrome: a meta-analysis of randomized, controlled trials

a.sfakia shared this article with you from Inoreader Early invasive strategy for non-ST elevation acute coronary syndrome: a meta-analysis of randomized, controlled trials Via SAGE Publications Ltd: Journal of International Medical Research: Table of Contents Journal of International Medical Research, Volume 48, Issue 10, October 2020. ObjectivePatients with non-ST elevation acute coronary syndrome (NSTE-ACS) benefit from coronary intervention, but the optimal timing for an invasive strategy is not well defined. This study aimed to determine whether an early invasive strategy (<12 hours) is superior to a delayed invasive strategy.MethodsTwelve studies of nine randomized, controlled trials of 8586 patients were included.ResultsThere were no significant differences in all-cause death (risk ratio [95% confidence interval]) (0.90, [0.77–1.06), re-myocardial infarction (re-MI) (0.95 [0.70–1.29]), major bleeding (0.97 [0.77–1.23]), and refractory ischemia (0.74 [0.53–1.05]) when we compared use of early and delayed invasive strategies. Furthermore, analysis of the effect of the chosen strategy on high-risk patients showed that the rate of composite death or re-MI was significantly decreased in patients with either a Global Registry of Acute Coronary Events (GRACE) risk score >140 or with elevated troponin levels (risk ratio 0.82 [0.72–0.92]; risk ratio 0.84 [0.76–0.93], respectively).ConclusionsThis meta-analysis shows that an early angiographic strategy does not improve clinical outcome in patients with NSTE-ACS. An early invasive strategy might reduce the rate of composite death or re-MI in high-risk patients with GRACE risk scores >140 or elevated cardiac markers. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.