Optimal Timing of Coronary Invasive Strategy in Non–ST-Segment Elevation Acute Coronary Syndromes

Navarese, Eliano Pio; Gurbel, Paul A.; Andreotti, Felicita; Tantry, Udaya S.; Jeong, Yi Yeong; Koziński, Marek; Engstrøm, Thomas; Pasquale, Giuseppe Di; Kochman, Wacław; Ardissino, Diego; Kedhi, Elvin; Stone, Gregg W.; Kubica, Jacek

doi:10.7326/0003-4819-158-4-201302190-00006

Cited by 158 publications

(86 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Jest to maksymalne zalecane odroczenie koronarografii u pacjentów bez nawrotu objawów, lecz spełniających przynajmniej jedno kryterium umiarkowanego ryzyka [324,327]. Nawet w razie konieczności transportu chorego do innego szpitala koronarografię należy wykonać w ciągu 72 h.…”

Section: Strategia Inwazyjna (< 72 H)unclassified

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

Self Cite

207

165

View full text Add to dashboard Cite

Section: Strategia Inwazyjna (< 72 H)unclassified

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

Self Cite

207

165

View full text Add to dashboard Cite

“…A recent meta-analysis showed that current randomized controlled studies are inconclusive with regard to survival benefit associated with early (typically Ͻ24 hours) versus delayed invasive strategy in patients presenting with NSTEMI (OR, 0.83; 95% CI, 0.64 -1.09; P ϭ .180). 10 Early invasive coronary angiography is recommended in NSTEMI/UA patients with refractory angina or hemodynamic or electric instability (strength of recommendation A). Early invasive strategy is reasonable for higher-risk patients with NSTEMI/UA previously stabilized who do not have serious comorbidities (i.e., liver or pulmonary failure, cancer) or contraindications to the procedure (strength of recommendation B).…”

Section: Coronary Revascularizationmentioning

confidence: 99%

Diagnosis and Management of Acute Coronary Syndrome: An Evidence-Based Update

Smith¹,

Negrelli²,

Manek³

et al. 2015

The Journal of the American Board of Family Medicine

124

View full text Add to dashboard Cite

Acute coronary syndrome (ACS) describes the range of myocardial ischemic states that includes unstable angina, non-ST elevated myocardial infarction (MI), or ST-elevated MI. ACS is associated with substantial morbidity and mortality and places a large financial burden on the health care system. The diagnosis of ACS begins with a thorough clinical assessment of a patient's presenting symptoms, electrocardiogram, and cardiac troponin levels as well as a review of past medical history. Early risk stratification can assist clinicians in determining whether an early invasive management strategy or an initial conservative strategy should be pursued and can help determine appropriate pharmacologic therapies. Key components in the management of ACS include coronary revascularization when indicated; prompt initiation of dual antiplatelet therapy and anticoagulation; and consideration of adjuvant agents including ␤ blockers, inhibitors of the renin angiotensin system, and HmG-coenzyme A reductase inhibitors. It is essential for clinicians to take an individualized approach to treatment and consider long-term safety and efficacy when managing patients with a history of ACS after hospital discharge. The term myocardial infarction (MI) is used when there is evidence of myocardial necrosis in the setting of acute myocardial ischemia. STEMI is differentiated from NSTEMI by the presence of persistent ECG findings of ST segment elevation. 3In recent years, progress has been made in the management of ACS, particularly related to optimizing pharmacotherapy. 2,3 Family physicians care for patients presenting with ACS in office as well as emergency settings and play an important role in both acute and long-term management of such patients. In this article, we review the topic of ACS with particular emphasis on initial management and use of the newer medications. Specific coronary interventions performed by the cardiologist (eg, stents or balloon angioplasty) are beyond the scope of this review. Scope of the ProblemCoronary heart disease (CHD) is responsible for more than half of all cardiovascular events in individuals less than 75 years of age. The prevalence of This article was externally peer reviewed.

show abstract

“…Several international guidelines recommend that NSTEMI patients should undergo CAG within 72 hours after hospitalisation and some have advocated for a 24-hour limit [33–35]. In 2015, 57% of NSTEMI patients in our region weres treated within 72 hours.…”

Section: Discussionmentioning

confidence: 99%

Treatment of acute myocardial infarction in the sub-arctic region of Norway. Do we offer an equal quality of care?

Norum

Hovland

Balteskard

et al. 2017

International Journal of Circumpolar Health

View full text Add to dashboard Cite

Patients, relatives, healthcare workers and administrators are concerned about the quality of care offered. We aimed to explore the treatment of acute myocatrdial infarction (AMI) in Northern Norway, compare it with the national figures, and document whether there is an equal quality of care or not. The retrospective study included data on patients' treatment for AMI. The following sources were employed. The Norwegian Patient Registry, National Quality of Care Database, Norwegian Myocardial Infarction Registry and data from the National Air Ambulance Services of Norway. The period 2012-2014/15 was studied and the variables were: incidence of AMI, gender and age adjusted rates of AMI and revascularization (PCI, CABG) based on patient's place of living (according to hospital catchment area) and 30-day survival rate. The annual incidence of AMI was 9% higher in the northern region. Significant incidence variations (2.7–5.9 AMI/1000 inhabitants) between the hospitals' catchment areas were revealed. The 30-day survival rate varied between 85.1–92.1% between hospitals. The variation in revascularization/AMI rate was 0.72–1.54. Air amublance services' availability varied through the day. In conclusion, significant variations in the AMI rate and an unequal service within the region was revealed.

show abstract

Optimal Timing of Coronary Invasive Strategy in Non–ST-Segment Elevation Acute Coronary Syndromes

Cited by 158 publications

References 23 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

Diagnosis and Management of Acute Coronary Syndrome: An Evidence-Based Update

Treatment of acute myocardial infarction in the sub-arctic region of Norway. Do we offer an equal quality of care?

Contact Info

Product

Resources

About