Evaluation of early interventional treatment opportunity of the elderly and high-risk patients with non-ST segment elevation acute myocardial infarction

Abstract

Objective:To investigate the effect of treatment on prognosis of patients with different timing of early interventional treatment for non-ST segment elevation acute myocardial infarction (NSTEMI).Methods:Forty two cases above 75 years old, diagnosed with high-risk on NSTEMI, were selected in cardiology department of Xinxiang central hospital. They were randomly divided into two groups: 22 in group A and 20 in group B. Group A was performed PCI surgery within 12 hours after the onset while group B from 12 to 24 hour after the onset. Major adverse cardiovascular events (including death, heart failure readmission rates after ischemia, malignant arrhythmias, again target vessel revascularization) and bleeding data were recorded at the three terms of hospitalization, one month after the onset and six months after the onset.Results:Angina, malignant arrhythmia and heart failure during hospitalization can be reduced after interventional treatment carried out within 12 hours after the onset. Readmission rates after ischemia, heart failure and the incidence of death can be significantly reduced after interventional treatment carried out during 1-6 month after the onset with no significant increase in bleeding rate.Conclusion:In the treatment of elderly patients with NSTEMI, early interventional treatment is safe and effective.

Timing of invasive strategy in non-ST-elevation acute coronary syndrome: a meta-analysis of randomized controlled trials

“… c In the trials by Liu et al . 18 and Tekin et al ., 17 median timing of ICA for each group was not provided. Timing targets specified in the study methodology are listed.…”

“… 17 and Liu et al . 18 studies did not provide median timing to angiography data, rather target thresholds for each group.…”

“…The bars represent median time and interquartile ranges in the early invasive strategy group (red) and the delayed invasive strategy group (blue). The Tekin et al 17 and Liu et al 18 studies are not displayed as medians were not reported. Interquartile ranges were not reported in the OPTIMA and Zhang et al 14 trials.…”

Immediate/Early vs. Delayed Invasive Strategy for Patients with Non-ST-Segment Elevation Acute Coronary Syndromes: A Systematic Review and Meta-Analysis

“…However, at present, the optimal timing of routine invasive intervention is still controversial because of the conflicting reports of existed randomized controlled trials (RCTs) comparing early vs. delayed invasive approaches (Neumann et al, 2003 ; van't Hof et al, 2003 ; Mehta et al, 2009 ; Montalescot et al, 2009 ; Riezebos et al, 2009 ; Sciahbasi et al, 2010 ; Zhang et al, 2010 ; Thiele et al, 2012 ; Badings et al, 2013 ; Tekin et al, 2013 ; Liu et al, 2015 ; Reuter et al, 2015 ; Milosevic et al, 2016 ; Oosterwerff et al, 2016 ). Meta-analysis in recent years has also shown insufficient evidence either in favor of or against an early invasive strategy in the NSTE-ACS population (Navarese et al, 2011 , 2013 ; Milasinovic et al, 2015 ; Jobs et al, 2017 ).…”

“…One of the main limitations of the published meta-analysis was the small number of included studies. After literature retrieval, we updated four new studies (Liu et al, 2015 ; Reuter et al, 2015 ; Milosevic et al, 2016 ; Oosterwerff et al, 2016 ), hoping to gain a further conclusion with a larger sample size. In addition, by observing the data, we found that several studies used “<2 h” as the timing for immediate invasive therapy (Montalescot et al, 2009 ; Riezebos et al, 2009 ; Thiele et al, 2012 ; Milosevic et al, 2016 ; Oosterwerff et al, 2016 ).…”