Timing of angiography with a routine invasive strategy and long-term outcomes in non-ST-segment elevation acute coronary syndrome: a collaborative analysis of individual patient data from the FRISC II (Fragmin and Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction) Trials

JACC. Cardiovascular Interventions
Peter DammanRobbert J de Winter

Abstract

This study sought to investigate long-term outcomes after early or delayed angiography in patients with non-ST-segment elevation acute coronary syndrome (nSTE-ACS) undergoing a routine invasive management. The optimal timing of angiography in patients with nSTE-ACS is currently a topic for debate. Long-term follow-up after early (within 2 days) angiography versus delayed (within 3 to 5 days) angiography was investigated in the FRISC-II (Fragmin and Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction) (FIR) nSTE-ACS patient-pooled database. The main outcome was cardiovascular death or myocardial infarction up to 5-year follow-up. Hazard ratios (HR) were calculated with Cox regression models. Adjustments were made for the FIR risk score, study, and the propensity of receiving early angiography using inverse probability weighting. Of 2,721 patients originally randomized to the routine invasive arm, consisting of routine angiography and subsequent revascularization if suitable, 975 underwent early a...Continue Reading

References

Aug 24, 2000·Epidemiology·J M RobinsB Brumback
Dec 8, 2000·Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology·M Galli
Apr 24, 2004·Journal of Interventional Cardiology·Peter A McCulloughUNKNOWN TACTICS-TIMI-18 Investigators
Nov 27, 2007·Journal of the American College of Cardiology·Kristian ThygesenUNKNOWN Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction
May 22, 2009·The New England Journal of Medicine·Shamir R MehtaUNKNOWN TIMACS Investigators
Aug 28, 2009·The New England Journal of Medicine·Peter DammanRobbert de Winter
Sep 3, 2009·JAMA : the Journal of the American Medical Association·Gilles MontalescotUNKNOWN ABOARD Investigators

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Citations

Jul 29, 2021·Arquivos brasileiros de cardiologia·José Carlos NicolauWilson Mathias Júnior

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