Why the study?
Guideline-recommended angiographic timing strategies face organizational critical issues in Italy that often prevent revascularization within 24 hours or same-day spoke-to-hub transfers.
This position paper adapts European guidelines on the timing of coronary angiography for NSTEMI patients to the specific organizational realities of the Italian healthcare system.
Tailors NSTEMI angiography timing to Italian realities; extends European guidelines for national implementation.
The European Society of Cardiology guidelines on non-ST-elevation acute coronary syndromes suggest different temporal strategies for the angiographic study depending on the risk profile. The scientific evidence underlying the guideline recommendations and the critical issues currently existing in Italy, that often do not allow either an extended strategy of revascularization within 24 h or the application of the principle of the same day transfer from a spoke to a hub centre, are analysed. The position paper focuses, in particular, on the subgroup of patients with a defined diagnosis of non-ST-elevation myocardial infarction by proposing a timing of coronary angiography/revascularization that takes into account the available scientific evidence and the organizational possibilities of a considerable part of national cardiology services.
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Murrone et al. (2021) conducted a review in non-ST-segment elevation acute coronary syndromes. Timing of coronary angiography was evaluated. This position paper proposes a timing strategy for coronary angiography and revascularization in non-ST-elevation myocardial infarction adapted to the organizational realities of Italian cardiology.
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