Optimal Timing of Invasive Coronary Angiography following NSTEMI
Why the study?
Guidelines recommend angiography within 24 hours of admission for NSTEMI, and the VERDICT trial suggested benefit within 12 hours among high-risk patients, prompting assessment in a real-world cohort.
Does invasive coronary angiography within 12 hours of admission reduce one-year MACE in NSTEMI patients compared to angiography 12 to 24 hours after admission?
Population
1832 NSTEMI patients without life-threatening features receiving angiography within 24 hours in Switzerland
Comparison
Angiography within 12 hours vs 12 to 24 hours after admission
Design
Multicenter registry-based cohort study with propensity score matching
Follow-up
One-year
Authors
Discussion
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Member takes
Implication
Angiography within 12 h was not associated with lower one-year MACE than 12-24 h; leaves open optimal timing and requires RCTs.
Structured PICO
Does invasive coronary angiography within 12 hours of admission reduce one-year MACE in NSTEMI patients compared to angiography 12 to 24 hours after admission?
P
Population
1,832 NSTEMI patients without life-threatening features who received angiography within 24 hours of admission, from the SPUM-ACS registry (four university hospitals in Switzerland).
I
Intervention
Invasive coronary angiography within 12 hours of admission
C
Comparator
Invasive coronary angiography 12 to 24 hours after admission
O
Outcome
One-year major adverse cardiovascular events (MACE: cardiovascular mortality, myocardial infarction, and stroke)composite
In a real-world cohort of NSTEMI patients, performing invasive coronary angiography within 12 hours of admission did not significantly improve one-year cardiovascular outcomes compared to 12-24 hours, even among high-risk patients.
Cite This Study
Mahendiran et al. (2020) studied this question.