Key result
PCI timing in NSTEMI shows no association with MACE up to six months.
Why the study?
The timing of coronary angiography in patients with non-ST elevation myocardial infarction (NSTEMI) needs to be well defined.
Does early PCI (<12 hours or 12-24 hours) reduce major adverse cardiovascular events compared to delayed PCI (≥24 hours) in NSTEMI patients?
Cohort (n=156)
No
Does early PCI (<12 hours or 12-24 hours) reduce major adverse cardiovascular events compared to delayed PCI (≥24 hours) in NSTEMI patients?
In this single-center cohort of NSTEMI patients, the timing of PCI (<12 hours, 12-24 hours, or ≥24 hours) did not significantly impact the incidence of major adverse cardiovascular events at up to 6 months of follow-up.
Answers are grounded in this paper and cite their sources.
No difference in MACE by PCI timing; leaves open optimal window in NSTEMI pending randomized data.
BACKGROUND: The timing of coronary angiography in patients with non-ST elevation myocardial infarction (NSTEMI) needs to be well defined. In this study, based on the timing of percutaneous coronary intervention (PCI), we evaluated the incidence of major adverse cardiovascular events (MACE) in NSTEMI patients. METHODS: In this longitudinal study, we included 156 NSTEMI patients who underwent a PCI at three time points, including <12 hr. (n = 53), 12-24 hr. (n = 54), and ≥24 hr. (n = 49) and followed them for one, three, and six months to monitor major cardiovascular events. The data analyses were conducted using SPSS version 20. RESULT: Four patients (2.56%) were hospitalized during the one-month follow-up, and only one patient (0.06%) had NSTEMI. The incidence of complications, such as readmission, acute coronary syndrome (ACS; 4 patients [2.56%]), and unstable angina (UA; 3 patients [1.92%]) did not differ significantly among the three intervention times. The occurrence of NSTEMI, UA, and recurrent PCI was 2.56%, 3.20%, and 5.12% in four, five, and eight patients, respectively, and no significant differences were observed among the aforementioned times. In the follow-up after six months, the incidence of STEMI, stroke, TLR, and other all-course deaths was observed in one person (0.06%), which all occurred within 12-24 hours. The difference among the three intervention times was non-significant. CONCLUSION: Our findings revealed an insignificant difference between the incidence of complications and the three-intervention time.
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Rouhollah Hemmati (2024) conducted a cohort in Non-ST-elevation myocardial infarction (NSTEMI) (n=156). Timing of percutaneous coronary intervention (PCI) vs. <12 hours vs 12-24 hours vs ≥24 hours was evaluated on Major adverse cardiovascular events (MACE) at 1, 3, and 6 months. Timing of percutaneous coronary intervention (<12, 12-24, or ≥24 hours) in NSTEMI patients did not significantly affect the incidence of major cardiovascular events at 1, 3, and 6 months.
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