当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY期刊下所有文献 > Impact of delay to angioplasty in patients with acute coronary syndromes undergoing invasive management: analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage strategY) trial.

Impact of delay to angioplasty in patients with acute coronary syndromes undergoing invasive management: analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage strategY) trial.

Abstract：

OBJECTIVES:The aim of this study was to determine the impact of delay to angioplasty in patients with acute coronary syndromes (ACS). BACKGROUND:There is a paucity of data on the impact of delays to percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) undergoing an invasive management strategy. METHODS:Patients undergoing PCI in the ACUITY (Acute Catheterization and Urgent Intervention Triage strategY) trial were stratified according to timing of PCI after clinical presentation for outcome analysis. RESULTS:Percutaneous coronary intervention was performed in 7,749 patients (median age 63 years; 73% male) with NSTE-ACS at a median of 19.5 h after presentation (<8 h [n=2,197], 8 to 24 h [n=2,740], and >24 h [n=2,812]). Delay to PCI>24 h after clinical presentation was significantly associated with increased 30-day mortality, myocardial infarction (MI), and composite ischemia (death, MI, and unplanned revascularization). By multivariable analysis, delay to PCI of >24 h was a significant independent predictor of 30-day and 1-year mortality. The incremental risk of death attributable to PCI delay>24 h was greatest in those patients presenting with high-risk features. CONCLUSIONS:In this large-scale study, delaying revascularization with PCI>24 h in patients with NSTE-ACS was an independent predictor of early and late mortality and adverse ischemic outcomes. These findings suggest that urgent angiography and triage to revascularization should be a priority in NSTE-ACS patients.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Sorajja P,Gersh BJ,Cox DA,McLaughlin MG,Zimetbaum P,Costantini C,Stuckey T,Tcheng JE,Mehran R,Lansky AJ,Grines CL,Stone GW

doi

10.1016/j.jacc.2009.11.063

subject

Has Abstract

pub_date

2010-04-06 00:00:00

pages

1416-24

issue

14

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(10)00340-2

journal_volume

55

pub_type

杂志文章

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