PMID- 28409008
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240327
IS  - 2053-3624 (Print)
IS  - 2053-3624 (Electronic)
IS  - 2053-3624 (Linking)
VI  - 4
IP  - 1
DP  - 2017
TI  - Two-year outcome after early or late Intervention in non-ST elevation acute 
      coronary syndrome.
PG  - e000538
LID - 10.1136/openhrt-2016-000538 [doi]
LID - e000538
AB  - OBJECTIVE: To compare long-term outcome of an early to a delayed invasive 
      strategy in high-risk patients with non-ST elevation acute coronary syndrome 
      (NSTE-ACS). METHODS: This prospective, multicentre trial included patients with 
      NSTE-ACS and at least two out of three of the following high-risk criteria: (1) 
      evidence of extensive myocardial ischaemia on ECG, (2) elevated biomarkers for 
      myocardial necrosis and (3) age above 65 years. Patients were randomised to 
      either an early (angiography and revascularisation if appropriate <12 hours) or a 
      delayed invasive strategy (>48 hours after randomisation). Endpoint for this 
      prespecified long-term follow-up was the composite incidence of death or 
      reinfarction after 2 years. Data collection was performed by telephone contact 
      with the patients, their relatives or general practitioner and by review of 
      hospital records. RESULTS: Endpoint status after 2-year follow-up was collected 
      in 521 of 542 initially enrolled patients. Incidence of death or reinfarction was 
      11.8% in the early and 13.1% in the delayed treatment group (relative risk 
      (RR)=0.90, 95% CI 0.57 to 1.42). No significant differences were found in 
      occurrence of the individual components of the primary endpoint: death 6.1% vs 
      8.9%, RR 0.69 (95% CI 0.37 to 1.27), reinfarction 6.5% vs 5.4%, RR 1.20 (95% CI 
      0.60 to 2.38). Post-hoc subgroup analysis showed statistical significant 
      interaction between age and treatment strategy on outcome (p=0.02). CONCLUSIONS: 
      After 2 years follow-up, no difference in incidence of death or reinfarction was 
      seen between early to late invasive strategy. These findings are in line with 
      results of other studies with longer follow-up. Older patients seem to benefit 
      more from early invasive treatment.
FAU - Badings, Erik A
AU  - Badings EA
AD  - Department of Cardiology, Deventer Ziekenhuis, Deventer, Netherlands.
FAU - Remkes, Wouter S
AU  - Remkes WS
AD  - Department of Cardiology, Isala klinieken, Zwolle, Netherlands.
FAU - The, Salem H K
AU  - The SH
AD  - Department of Cardiology, Treant Zorggroep locatie ziekenhuis Bethesda, 
      Hoogeveen, Netherlands.
FAU - Dambrink, Jan-Henk E
AU  - Dambrink JE
AD  - Department of Cardiology, Isala klinieken, Zwolle, Netherlands.
FAU - Tjeerdsma, Geert
AU  - Tjeerdsma G
AD  - Department of Cardiology, Ziekenhuis De Tjongerschans, Heerenveen, Netherlands.
FAU - Rasoul, Saman
AU  - Rasoul S
AD  - Department of Cardiology, Maastricht UMC, Maastricht, Netherlands.
AD  - Department of Cardiology, Atrium Medisch Centrum, Heerlen, Netherlands.
FAU - Timmer, Jorik R
AU  - Timmer JR
AD  - Department of Cardiology, Isala klinieken, Zwolle, Netherlands.
FAU - van der Wielen, Marloes L J
AU  - van der Wielen ML
AD  - Department of Cardiology, Treant Zorggroep locatie ziekenhuis Bethesda, 
      Hoogeveen, Netherlands.
FAU - Lok, Dirk J A
AU  - Lok DJ
AD  - Department of Cardiology, Deventer Ziekenhuis, Deventer, Netherlands.
FAU - Hermanides, Renicus S
AU  - Hermanides RS
AD  - Department of Cardiology, Isala klinieken, Zwolle, Netherlands.
FAU - Van Wijngaarden, Jan
AU  - Van Wijngaarden J
AD  - Department of Cardiology, Deventer Ziekenhuis, Deventer, Netherlands.
FAU - Suryapranata, Harry
AU  - Suryapranata H
AD  - Department of Cardiology, Isala klinieken, Zwolle, Netherlands.
AD  - Department of Cardiology, Radboudumc, Nijmegen, Netherlands.
FAU - van 't Hof, Arnoud W J
AU  - van 't Hof AW
AD  - Department of Cardiology, Isala klinieken, Zwolle, Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20170302
PL  - England
TA  - Open Heart
JT  - Open heart
JID - 101631219
PMC - PMC5384464
OTO - NOTNLM
OT  - Acute coronary syndromes
OT  - Percutaneous coronary intervention
COIS- Competing interests: None declared.
EDAT- 2017/04/15 06:00
MHDA- 2017/04/15 06:01
PMCR- 2017/03/02
CRDT- 2017/04/15 06:00
PHST- 2016/09/14 00:00 [received]
PHST- 2016/12/05 00:00 [revised]
PHST- 2017/01/10 00:00 [accepted]
PHST- 2017/04/15 06:00 [entrez]
PHST- 2017/04/15 06:00 [pubmed]
PHST- 2017/04/15 06:01 [medline]
PHST- 2017/03/02 00:00 [pmc-release]
AID - openhrt-2016-000538 [pii]
AID - 10.1136/openhrt-2016-000538 [doi]
PST - epublish
SO  - Open Heart. 2017 Mar 2;4(1):e000538. doi: 10.1136/openhrt-2016-000538. 
      eCollection 2017.