Timing of coronary angiography in patients with non-ST-elevation acute coronary syndrome: long-term clinical outcomes from the nationwide SWEDEHEART registry
Key result
Delaying angiography to 24-72 hours shows no mortality difference vs. <24 hours in NSTE-ACS.
- HR 1.01
- 95% CI 0.92-1.11
- n=34,666
Why the study?
Current guidelines emphasize early invasive assessment in NSTE-ACS patients, especially high-risk, but supporting scientific evidence is limited.
Does early coronary angiography (<24 hours) improve long-term clinical outcomes compared to delayed angiography (24-72 hours) in patients with NSTE-ACS?
Population
34,666 NSTE-ACS patients from the SWEDEHEART registry (2013-2018)
Comparison
Coronary angiography <24 hours vs 24-72 hours from admission
Design
Retrospective cohort analysis
Authors
Discussion
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Member takes
Implication
Should not yet change NSTE-ACS angiography timing; leaves open optimal window for randomized trials.
Study Design
Type
Cohort (n=34,666)
Multicenter
Yes
Structured PICO
Does early coronary angiography (<24 hours) improve long-term clinical outcomes compared to delayed angiography (24-72 hours) in patients with NSTE-ACS?
P
Population
34,666 patients with non-ST-elevation acute coronary syndrome registered in the nationwide SWEDEHEART registry from 2013 to 2018.
E
Exposure
Early coronary angiography (<24 hours from admission)
C
Comparator
Delayed coronary angiography (24-72 hours from admission)
O
Outcome
All-cause mortality and major adverse eventshard clinical
Main Result
Hazard Ratio: 1.01 (95% CI 0.92–1.11)
In a large nationwide registry of NSTE-ACS patients, an early invasive strategy (<24 hours) did not provide a prognostic benefit compared to a 24-72 hour window, challenging current guideline recommendations for early invasive assessment in high-risk patients.
Cite This Study
Eggers et al. (2022) conducted a cohort in non-ST-elevation acute coronary syndrome (NSTE-ACS) (n=34,666). Coronary angiography within 24-72 hours vs. Coronary angiography <24 hours was evaluated on all-cause mortality (HR 1.01, 95% CI 0.92-1.11). Coronary angiography within 24-72 hours compared to <24 hours was not associated with worse all-cause mortality (HR 1.01; 95% CI 0.92-1.11) in patients with NSTE-ACS.