Key result
Early angiography in NSTE-ACS fails to reduce death or MI but cuts recurrent ischemia ~41%.
Why the study?
The optimal timing of coronary angiography and subsequent intervention in patients with NSTE-ACS has not been settled.
Does early coronary angiography reduce death, MI, or recurrent ischemia compared to delayed angiography in patients with NSTE-ACS?
Comparison
Early coronary angiography (1.16 to 14 h) vs delayed coronary angiography (20.8 to 86 h)
Design
Meta-analysis of randomized trials
Authors
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Does not reduce death or MI in NSTE-ACS; reinforces delayed strategy as safe while confirming ischemia reduction.
Meta-Analysis (n=4,013)
Yes
Does early coronary angiography reduce death, MI, or recurrent ischemia compared to delayed angiography in patients with NSTE-ACS?
Relative Risk: 0.85 (95% CI 0.64–1.11)
In patients with NSTE-ACS, an early invasive strategy does not significantly reduce death or MI compared to a delayed strategy, but it does reduce recurrent ischemia and hospital length of stay.
Demosthenes G. Katritsis (2010) conducted a meta-analysis in acute coronary syndromes without ST-segment elevation (NSTE-ACS) (n=4,013). Early coronary angiography vs. Delayed coronary angiography was evaluated on death (RR 0.85, 95% CI 0.64-1.11). Early coronary angiography in NSTE-ACS did not significantly reduce the risk of death (RR 0.85; 95% CI 0.64-1.11) or MI, but significantly reduced recurrent ischaemia (RR 0.59; 95% CI 0.38-0.92).
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