PMID- 24486660
OWN - NLM
STAT- MEDLINE
DCOM- 20140930
LR  - 20161125
IS  - 1557-2501 (Electronic)
IS  - 1042-3931 (Linking)
VI  - 26
IP  - 2
DP  - 2014 Feb
TI  - Timing of early angiography in non-ST elevation acute coronary syndrome.
PG  - 47-54
AB  - OBJECTIVES: We aimed to determine the best time period for an early invasive 
      intervention in non-ST elevation acute coronary syndrome (NSTEACS) patients. 
      BACKGROUND: Studies assessing the timing of percutaneous coronary intervention 
      (PCI) in patients with NSTEACS have failed to generate a consensus on when PCI 
      should be performed in such patients. METHODS: Literature searches were conducted 
      for randomized, controlled trials (RCTs) on NSTEACS from 1970 through September 
      2012. Patients were analyzed who were at moderate to high risk for NSTEACS and 
      who underwent angiography within 96 hours. The major outcomes were the rate of 
      death, recurrent myocardial infarction (re-MI), stroke, and major bleeding. 
      RESULTS: Eight RCTs, which included 5761 patients, were eligible. There were no 
      significant differences in the odds of death or stroke between time points. 
      Conversely, patients undergoing angiography before 2 hours were associated with a 
      higher rate of re-MI, compared with those undergoing angiography more than 2 
      hours later (odds ratio [OR], 2.15; 95% confidence interval [CI], 1.53-3.02; 
      P<.001; I(2) = 0%). Major bleeding events decreased only with angiography performed 
      within 12 hours, compared to more than 12 hours (OR, 0.65; 95% CI, 0.44-0.96; 
      P=.03; I(2) = 0%). Angiography before 2 hours was not associated with a lower rate 
      of major bleeding compared with angiography after 2 hours (OR, 0.61; 95% CI, 
      0.28-1.30; P=.20; I(2) = 0%). CONCLUSIONS: Angiography within 12 hours reduces the 
      risk of major bleeding. There is no need to push for angiography within 2 hours.
FAU - Jiang, Meng
AU  - Jiang M
AD  - Department of Cardiology, Renji Hospital, Shanghai Jiaotong University, School of 
      Medicine, Shanghai, China 200127. heben1025@126.com.
FAU - Mao, Jia-liang
AU  - Mao JL
FAU - Pu, Jun
AU  - Pu J
FAU - He, Ben
AU  - He B
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
SB  - IM
MH  - Acute Coronary Syndrome/*diagnostic imaging/*therapy
MH  - Aged
MH  - *Coronary Angiography
MH  - *Electrocardiography
MH  - Female
MH  - Hemorrhage/epidemiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/prevention & control
MH  - *Percutaneous Coronary Intervention
MH  - Risk Factors
MH  - Secondary Prevention
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2014/02/04 06:00
MHDA- 2014/10/01 06:00
CRDT- 2014/02/04 06:00
PHST- 2014/02/04 06:00 [entrez]
PHST- 2014/02/04 06:00 [pubmed]
PHST- 2014/10/01 06:00 [medline]
PST - ppublish
SO  - J Invasive Cardiol. 2014 Feb;26(2):47-54.