Results of early and delayed invasive approaches in managing patients with non-ST elevation acute coronary syndrome
Tsvetkov R. S., Mironkov A. B., Pryamikov A. D.
Keywords: non-ST elevation ACS, transcatheter coronary intervention
Background. Reports on advantages of early and delayed invasive approaches in the treatment of patients with unstable angina / non-ST elevation MI are inconsistent. Aim. To compare outcomes of early and delayed approaches in the treatment of patients with non-ST elevation ACS (nSTEACS) and different GRACE risk scores. Materials and methods. 60 patients were divided into two groups: early intervention (n=30) and delayed intervention (n=30). In the early intervention group, coronary angiography (CAG) with subsequent transcutaneous coronary intervention (TCCI) was performed urgently (0.5 to 3 hours of admission); in the delayed intervention group, TCCI was performed within 2 to 7 days. Results. Early outcomes did not significantly differ between the treatment groups. In the remote period (30 days to 12 months), incidence of fatal outcome differed significantly (p=0.001) in favor of the delayed intervention. Significant differences between other indices (acute MI and angina relapse) were absent. Conclusion. Delayed CAG with subsequent endovascular revascularization is a method, which is effective and no less safe than urgent intervention for managing patients with nSTEACS whose condition cannot be stabilized with drugs.
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Tsvetkov R.S., Mironkov A.B., Pryamikov A.D. Results of early and delayed invasive approaches in managing patients with non-ST elevation acute coronary syndrome. Russian Heart Journal. 2014;79 (5):271–277