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Fagel ND, Amoroso G, Rabbering T, et al. One-year mortality in NSTEMI patients is unaffected by timing of PCI within the first week of admission: Results of a real-world cohort analysis. Catheter Cardiovasc Interv. 2021;98(5):E661-E667doi: 10.1002/ccd.29873.
Fagel, N. D., Amoroso, G., Rabbering, T., Gescher, F., Vink, M. A., Slagboom, T., van der Schaaf, R. J., Herrman, J. R., Patterson, M. S., Vos, N. S., Verbeek, E. C., de Winter, R. J., & Riezebos, R. K. (2021). One-year mortality in NSTEMI patients is unaffected by timing of PCI within the first week of admission: Results of a real-world cohort analysis. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 98(5), E661-E667. https://doi.org/10.1002/ccd.29873
Fagel, Nick D, et al. "One-year mortality in NSTEMI patients is unaffected by timing of PCI within the first week of admission: Results of a real-world cohort analysis." Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions vol. 98,5 (2021): E661-E667. doi: https://doi.org/10.1002/ccd.29873
Fagel ND, Amoroso G, Rabbering T, Gescher F, Vink MA, Slagboom T, van der Schaaf RJ, Herrman JR, Patterson MS, Vos NS, Verbeek EC, de Winter RJ, Riezebos RK. One-year mortality in NSTEMI patients is unaffected by timing of PCI within the first week of admission: Results of a real-world cohort analysis. Catheter Cardiovasc Interv. 2021 Nov 01;98(5):E661-E667. doi: 10.1002/ccd.29873. Epub 2021 Jul 15. PMID: 34263520.
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Catheter Cardiovasc Interv. 2021 Nov 01;98(5):E661-E667. doi: 10.1002/ccd.29873. Epub 2021 Jul 15.

One-year mortality in NSTEMI patients is unaffected by timing of PCI within the first week of admission: Results of a real-world cohort analysis.

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

Nick D Fagel, Giovanni Amoroso, Tanja Rabbering, Froukje Gescher, Maarten A Vink, Ton Slagboom, René J van der Schaaf, Jean-Paul R Herrman, Mark S Patterson, Nicola S Vos, Eva C Verbeek, Robbert J de Winter, Robert K Riezebos

Affiliations

  1. Heart Center, OLVG Hospital, Amsterdam, Netherlands.
  2. Heart Center, AUMC location AMC, Amsterdam, Netherlands.

PMID: 34263520 DOI: 10.1002/ccd.29873

Abstract

OBJECTIVES: We aimed to explore the impact of time to percutaneous coronary intervention (PCI) (T2P) on 1-year mortality in non-ST-elevation myocardial infarction (NSTEMI) patients.

BACKGROUND: The current guidelines recommend an early invasive strategy for NSTEMI patients. However, impact of an early invasive strategy on mortality is a matter of debate. For that reason, real world data are of great value to determine the optimal treatment window.

METHODS: This retrospective single center cohort study was performed in a high-volume PCI center in Amsterdam, The Netherlands. Intermediate- and high-risk NSTEMI patients undergoing PCI were included. The main discriminant was timing of PCI after admission (T2P), stratified according to different time windows (<24 h, 24-72 h, 72 h-7 days or >7 days). We analyzed 1-year mortality and the time distribution of overall survival.

RESULTS: In total, 848 patients treated between January 1, 2016 and January 1, 2018 were included in the analysis. T2P was <24 h in 145 patients, 24-72 h in 192 patients, 72 h-7 days in 275 patients, and >7 days in 236 patients. The mean GRACE-risk score was 127.1 (SD 28.7), 130.0 (33.1), 133.8 (32.1), and 148.7 (34.6) respectively, p = <0.001. After adjusting for confounders, 1-year mortality in patients with T2P <24 h did not significantly differ when compared with T2P 24-72 h (OR = 1.08; 95% CI = 0.33-3.51) and T2P 72 h-7 days (OR 1.72; 95% CI = 0.57-5.21) but was significantly higher in T2P >7 days (OR = 3.20; 95% CI = 1.06-9.68).

CONCLUSIONS: In an unselected cohort of patients with NSTEMI, treatment by PCI <24 h did not lead to improved survival as compared to aT2P <7 days strategy. Delay in PCI >7 days after admission resulted in worse outcome.

© 2021 Wiley Periodicals LLC.

Keywords: non-ST-elevation myocardial infarction; revascularization; survival; timing

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