Early versus Delayed Invasive Intervention in Acute Coronary Syndromes
Why the study?
Does routine early intervention (coronary angiography <= 24 hours) reduce the composite of death, myocardial infarction, or stroke compared to delayed intervention (>= 36 hours) in patients with acute coronary syndromes?
Population
3031 patients with acute coronary syndromes
Comparison
Routine early intervention vs Delayed intervention
Design
RCT, randomly assigned
Follow-up
6 months
Authors
Discussion
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Member takes
Implication
Early intervention fails to reduce the primary composite in ACS; reinforces delayed strategy as acceptable for most patients.
Structured PICO
Does routine early intervention (coronary angiography <= 24 hours) reduce the composite of death, myocardial infarction, or stroke compared to delayed intervention (>= 36 hours) in patients with acute coronary syndromes?
P
Population
3031 patients with acute coronary syndromes
I
Intervention
Routine early intervention (coronary angiography <= 24 hours after randomization)
C
Comparator
Delayed intervention (coronary angiography >= 36 hours after randomization)
O
Outcome
Composite of death, myocardial infarction, or stroke at 6 monthscomposite
Early invasive intervention (<= 24 hours) in acute coronary syndromes does not significantly reduce the primary composite of death, MI, or stroke at 6 months compared to delayed intervention, but it reduces refractory ischemia and benefits high-risk patients.
Cite This Study
Mehta et al. (2009) studied this question.