Optimal timing of invasive intervention for high-risk non-ST-segment-elevation myocardial infarction patients
Juan-Juan ZHENG1
Yue-Qiao SI1
Tian-Yang XIA2
Bing-Jun LU3
Chun-Yu ZENG2
Wei-Eric WANG1
1.Department of Geriatrics,Southwest Hospital,Third Military Medical University,Chongqing,China;Department of Cardiology,Daping Hospital,Third Military Medical University,Chongqing,China2.Department of Cardiology,Daping Hospital,Third Military Medical University,Chongqing,China3.Department of Geriatrics,Southwest Hospital,Third Military Medical University,Chongqing,China
摘要：OBJECTIVE To compare the immediate,early,and delayed percutaneous coronary intervention(PCI)strategies in non-ST-seg-ment-elevation myocardial infarction(NSTEMI)patients with high-risk.
METHODS Medical records of patients treated at the Daping Hospital,Third Military Medical University,Chongqing,China between 2011 and 2021 were retrospectively reviewed.Only patients with complete available information were included.All pa-tients assigned into three groups based on the timing of PCI including immediate(＜2 h),early(2-24 h)and delayed(＞24 h)in-tervention.Multivariable Cox hazards regression and simpler nonlinear models were performed.
RESULTS A total of 657 patients were included in the study.The median follow-up length was 3.29(interquartile range:1.45-4.85)years.Early PCI strategy improved the major adverse cardiac event(MACE)outcome compared to the immediate or delay-ed PCI strategy.Early PCI,diabetes mellitus,and left main or/and left anterior descending or/and left circumflex stenosis or/and right coronary artery ≥ 99％were predictors for MACE outcome.The optimal timing range for PCI to reduce MACE risk is 3-14 h post-admission.For high-risk NSTEMI patients,early PCI reduced primary clinical outcomes compared to immediate or delayed PCI,and the optimal timing range was 3-14 h post-admission.Delayed PCI was superior for NSTEMI with chronic kidney injury.
CONCLUSIONS Delayed invasive strategy was helpful to reduce the incidence of MACE for high-risk NSTEMI with chronic kidney injury.An immediate PCI strategy might increase the rate of MACE.
机标关键词：optimalelevationhigh-riskinfarctioninterventioninvasivemyocardialpatients
论文发表日期：2024-08-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 807-815 )