Wallentin L, Lindhagen L, Arnstrom E, Husted S, Janzon M, Johnsen SP, et al. Long-term outcome of a routine versus selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome a meta-analysis of individual patient data. 2005 353(11):1095–104.įox KA, Clayton TC, Damman P, Pocock SJ, de Winter RJ, Tijssen JG, et al. Early invasive versus selectively invasive management for acute coronary syndromes. 2001 344(25):1879–87.ĭe Winter RJ, Windhausen F, Cornel JH, Dunselman PH, Janus CL, Bendermacher PE, et al. Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban. 2002 360(9335):743–51.Ĭannon CP, Weintraub WS, Demopoulos LA, Vicari R, Frey MJ, Lakkis N, et al. Randomized Intervention Trial of unstable Angina. Interventional versus conservative treatment for patients with unstable angina or non-ST-elevation myocardial infarction: the British Heart Foundation RITA 3 randomised trial. 2000 356(9223):9–16.įox KA, Poole-Wilson PA, Henderson RA, Clayton TC, Chamberlain DA, Shaw TR, et al. Fast Revascularisation during Instability in Coronary artery disease. Outcome at 1 year after an invasive compared with a non-invasive strategy in unstable coronary-artery disease: the FRISC II invasive randomised trial. Wallentin L, Lagerqvist B, Husted S, Kontny F, Stahle E, Swahn E. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2019 40:237–269.Īmsterdam EA, Wenger NK, Brindis RG, Casey DE Jr, Ganiats TG, Holmes DR Jr, et al. Fourth universal definition of myocardial infarction (2018).Eur Heart J. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD, Group ESCSD. Total ischemic time: the correct focus of attention for optimal ST-segment elevation myocardial infarction care. Myocardial infarct size vs duration of coronary occlusion in dogs. The wavefront phenomenon of ischemic cell death. Reimer KA, Lowe JE, Rasmussen MM, Jennings RB. Comparison of long-term mortality of acute ST-segment elevation myocardial infarction and non-ST-segment elevation acute coronary syndrome patients after percutaneous coronary intervention. Outcomes in patients with non-ST-elevation acute coronary syndrome randomly assigned to invasive versus conservative treatment strategies: a meta-analysis. Association between hospital process performance and outcomes among patients with acute coronary syndromes. Peterson ED, Roe MT, Mulgund J, DeLong ER, Lytle BL, Brindis RG, et al. Predictors of one-year mortality at hospital discharge after acute coronary syndromes: a new risk score from the EPICOR (long-tErm follow uP of antithrombotic management patterns In acute CORonary syndrome patients) study. Pocock S, Bueno H, Licour M, Medina J, Zhang L, Annemans L, et al. Trends in incidence, severity, and outcome of hospitalized myocardial infarction. Roger VL, Weston SA, Gerber Y, Killian JM, Dunlay SM, Jaffe AS, et al. Trends in presenting characteristics and hospital mortality among patients with ST elevation and non-ST elevation myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006. Rogers WJ, Frederick PD, Stoehr E, Canto JG, Ornato JP, Gibson CM, et al. Papers of particular interest, published recently, have been highlighted as: The definition of “early” in the early invasive strategy has evolved over the past decade and currently pertains to an invasive strategy performed within 12–24 h of presentation. In higher-risk patients, there is a benefit for a more aggressive approach. We know that the early invasive strategy at least is safe and improves recurrent ischemia and refractory angina as well as the length of stay, lowering the cost. The picture is now a little clearer, but still much remains to be answered. The relatively recent guidelines and meta-analyses on the subject try to shed light on the issue of timing. This paper aims to discuss the importance of timeliness of invasive strategy in the treatment of NSTE-ACS as well as the state-of-the-art approach to this critical health problem. Despite improvements in the systems of care and interventional techniques, the mortality of NSTE-ACS patients remains high, and delays in the treatment of NSTE-ACS patients continue to be a problem. Most NSTE-ACS patients receive invasive therapies. Non-ST segment elevation acute coronary syndromes (NSTE-ACS) account for 70% of the patients with ACS.
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