J Med Assoc Thai 2020; 103 (4):50

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Effect of Timing of Coronary Invasive Procedure to Clinical Outcomes in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome
Hutayanon P Mail, Tantichutinant N , Piyayotai D , Muenkaew M , Bhumimuang K

Objective: Patients with Non-ST elevation-acute coronary syndrome (NSTE-ACS) should be treated with a coronary invasive strategy. Whether the timing of invasive procedure will affect the outcome of patients with NSTE-ACS is controversial and varied among centers. This study examined the effect of timing of coronary invasive strategy to clinical outcomes in patients with NSTEACS.

Materials and Methods: The study was conducted NSTE-ACS patients who were treated at Thammasat University Hospital between January 1, 2015 and December 31, 2016 and underwent coronary invasive procedures during hospitalization. Patients were classified into three groups according to the time interval from admission to angiography. Patients in group I underwent coronary angiography (CAG) within 24 hours; in group II between 24 and 72 hours; and in group III after 72 hours. The composite outcomes included all-cause mortality and myocardial infarction (MI) at one-year. The secondary outcomes were the occurrence rate of allcause mortality, in-hospital death, myocardial infarction, repeat revascularization and major bleeding.

Results: 202 patients with NSTE-ACS, 52 (25.7%) were assigned to group I, 61 (30.2%) to group II and 89 (44.1%) to group III. The composite outcomes occurred in 38 (18.8%) patients, 11 (21.2%) to group I, 9 (14.8%) to group II and 18 (20.2%) to group III (p = 0.619).

Conclusion: The differences in timing of coronary invasive strategy in NSTE-ACS patients had no effect to the composite outcomes of all cause death and MI at one-year.

Keywords: Timing of Angiography, Non-ST-Segment, Elevation myocardial infarction


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