April 1, 2004Journal of Interventional Cardiology
Timing of Angiography and Revascularization in Acute Coronary Syndromes:
Why the study?
Does early angiography (<48 hours) improve outcomes compared to later angiography (>48 hours) in patients with unstable angina and NSTEMI treated with upstream tirofiban and heparin?
Population
1,078 patients with unstable angina and non-ST-segment elevation myocardial infarction from the invasive arm…
Comparison
Early angiography vs Late angiography
Design
Cohort
Follow-up
6 months
Authors
Discussion
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Implication
Early catheterization was not associated with lower event rates; leaves open optimal angiography timing in upstream tirofiban-treated NSTE-ACS.
Structured PICO
Does early angiography (<48 hours) improve outcomes compared to later angiography (>48 hours) in patients with unstable angina and NSTEMI treated with upstream tirofiban and heparin?
P
Population
1,078 patients with unstable angina and non-ST-segment elevation myocardial infarction from the invasive arm of the TACTICS TIMI-18 Trial, treated with upstream intravenous tirofiban and heparin
I
Intervention
Early angiography (before 48 hours after randomization)
C
Comparator
Late angiography (after 48 hours after randomization)
O
Outcome
Composite of death, myocardial infarction (MI), or rehospitalization at 6 monthscomposite
In patients with NSTE-ACS treated with upstream glycoprotein IIb/IIIa inhibitors, early angiography (<48 hours) did not significantly reduce the composite of death, MI, or rehospitalization at 6 months compared to later angiography.
Limitations
- Groups were not randomized based on time
- Potential selection bias
Cite This Study
McCullough et al. (2004) studied this question.