Early Invasive vs Conservative Treatment Strategies in Women and Men With Unstable Angina and Non–ST-Segment Elevation Myocardial Infarction

O’Donoghue, Michelle L.; Boden, William E.; Braunwald, Eugene; Cannon, Christopher P.; Clayton, Tim; Winter, Robbert J. de; Fox, Keith A.A.; Lagerqvist, Bo; McCullough, Peter A.; Murphy, Sabina A.; Spacek, R; Swahn, Eva; Wallentin, Lars; Windhausen, Fons; Sabatine, Marc S.

doi:10.1001/jama.300.1.71

Cited by 411 publications

(208 citation statements)

References 36 publications

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“…Kobiety odnoszą w przybliżeniu taką samą korzyść z wczesnej strategii inwazyjnej jak mężczyźni [323,395]. W porównaniu z mężczyznami kobiety z NSTE-ACS, zwłasz-cza te w wieku < 60 lat, charakteryzuje 2-krotnie wyższe ryzyko zgonu wewnątrzszpitalnego, które następnie stopniowo…”

Section: Krwawienie Niezwiązane Z Dostępem Naczyniowymunclassified

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

Roffi¹,

Patrono²,

Collet³

et al. 2015

Kardiol Pol

189

158

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Section: Krwawienie Niezwiązane Z Dostępem Naczyniowymunclassified

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

Roffi¹,

Patrono²,

Collet³

et al. 2015

Kardiol Pol

189

158

View full text Add to dashboard Cite

“…In addition, there are sex‐based differences in the primary and secondary treatment of coronary disease 11, 12, 13. For instance, the use of an early invasive strategy of prompt coronary angiography with revascularization as appropriate is substantially lower in women once non‐ST elevation ACS is recognized,14, 15, 16, 17, 18, 19 even though high‐risk women may derive similar benefit from an invasive strategy as men 19, 20, 21. Some have therefore advocated that increased use of early revascularization, and sex‐specific thresholds for high‐sensitivity troponin, may mitigate existing sex differences in outcomes following presentation with ACS 17, 22, 23.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Women and Men With Acute Coronary Syndrome Treated With and Without Percutaneous Coronary Revascularization

Udell

Koh

Qiu

et al. 2017

JAHA

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BackgroundWomen hospitalized with a non‐ST segment elevation acute coronary syndrome (ACS) have worse clinical outcomes compared with men. An early invasive strategy with prompt coronary revascularization may mitigate sex differences in outcomes. However, few contemporary studies have evaluated whether clinical outcomes differ between women and men presenting with ACS treated with an early invasive strategy.Methods and ResultsA population‐based cohort of hospitalized ACS patients who received prompt cardiac catheterization from 2008 to 2011 in Ontario, Canada and followed for up to 2 years was studied. Clinical outcomes were compared between men and women, stratified by the use of coronary revascularization. Inverse probability weighting using the propensity score accounted for measured differences in baseline characteristics between men and women. Among the 23 473 ACS patients who received cardiac catheterization during an index hospitalization, 66.1% of men and 51.8% of women received coronary revascularization during the same hospitalization. In the propensity‐weighted cohort of patients who received coronary revascularization, the 1‐year rate of death or recurrent ACS was 10.6% for men (referent) compared with 13.1% for women (hazard ratio 1.24; 95% CI 1.16–1.33). In contrast, outcomes for patients who did not receive coronary revascularization did not differ significantly between women and men at 1 year (17.8% versus 16.9%; hazard ratio 1.06; 95% CI 0.99–1.14) or at longer follow‐up.ConclusionsAn increased risk of adverse clinical outcomes was observed for women with ACS undergoing an early invasive strategy and coronary revascularization compared with men.

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“…NSTEMIis more common (8) and has a poorer long-term prognosis (9) than STEMI. Revascularisation by means of PCI eliminates symptoms, shortens stays in hospital and improves the prognosis, also in the case of NSTEMI (10,11).…”

Section: Resultsmentioning

confidence: 99%

Følges retningslinjene for behandling av hjerteinfarkt?

Jortveit¹,

Grenne²,

Uchto³

et al. 2014

Tidsskriftet

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MAIN POINTSIn 2012, most patients with ST elevation myocardial infarction in southern Norway and in Telemark county underwent invasive examination and treatment within the recommended time frameMany patients with non-ST elevation infarction did not undergo invasive evaluation by the deadlines recommended in new guidelines.In order to bring about earlier invasive evaluation and treatment, more patients with myocardial infarction should be admitted directly to hospitals with PCI preparedness.BACKGROUND New guidelines recommend early invasive evaluation and treatment for most patients with acute myocardial infarction -including patients with myocardial infarction without ST elevation in the ECG. This study examines compliance with the new guidelines at Sørlandet Hospital Arendal.

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Early Invasive vs Conservative Treatment Strategies in Women and Men With Unstable Angina and Non–ST-Segment Elevation Myocardial Infarction

Cited by 411 publications

References 36 publications

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

Outcomes of Women and Men With Acute Coronary Syndrome Treated With and Without Percutaneous Coronary Revascularization

Følges retningslinjene for behandling av hjerteinfarkt?

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