Prognostic benefit from an early invasive strategy in patients with non ST elevation acute coronary syndrome (NSTEACS): evaluation of the new risk stratification in the NSTEACS European guidelines

Prognostic benefit from an early invasive strategy in patients with non ST elevation acute coronary syndrome (NSTEACS): evaluation of the new risk stratification in the NSTEACS European guidelines

Abstract Objectives The objective of our work is to evaluate the prognostic benefit of an early invasive strategy in patients with high-risk NSTACS according to the recommendations of the 2020 clinical practice guidelines during long-term follow-up. Methods This retrospective observational study inc...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:European heart journal 2021-10, Vol.42 (Supplement_1)
Hauptverfasser: Martinon-Martinez, J, Alvarez Alvarez, B, Gonzalez Ferrero, T, Garcia-Rodeja Arias, F, Otero Garcia, O, Cacho Antonio, C, Abou Jokh Casas, C, Cordero, A, Cid Alvarez, B, Iglesias Alvarez, D, Agra Bermejo, R, Rigueiro Veloso, P, Garcia Acuna, J M, Gude Sampedro, F, Gonzalez Juanatey, J R
Format: Artikel
Sprache:eng
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page
container_issue Supplement_1
container_start_page
container_title European heart journal
container_volume 42
creator Martinon-Martinez, J
Alvarez Alvarez, B
Gonzalez Ferrero, T
Garcia-Rodeja Arias, F
Otero Garcia, O
Cacho Antonio, C
Abou Jokh Casas, C
Cordero, A
Cid Alvarez, B
Iglesias Alvarez, D
Agra Bermejo, R
Rigueiro Veloso, P
Garcia Acuna, J M
Gude Sampedro, F
Gonzalez Juanatey, J R
description Abstract Objectives The objective of our work is to evaluate the prognostic benefit of an early invasive strategy in patients with high-risk NSTACS according to the recommendations of the 2020 clinical practice guidelines during long-term follow-up. Methods This retrospective observational study included 6454 consecutive NSTEACS patients. We analyze the effects of early coronary angiography (140 and (b) patients with “established NSTEMI” (non ST-segment elevation myocardial infarction defined by an increase in troponins) or dynamic ST-T-segment changes with a GRACE risk score 140 [HR 0.62 (IC 95% 0.57–0.67), HR 0.62 (IC 95% 0.56–0.68), HR 0.57 (IC 95% 0.53–0.61), respectively]. In patients with NSTEACS and GRACE
doi_str_mv 10.1093/eurheartj/ehab724.1475
format Article
fullrecord <record><control><sourceid>oup_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1093_eurheartj_ehab724_1475</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/eurheartj/ehab724.1475</oup_id><sourcerecordid>10.1093/eurheartj/ehab724.1475</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1375-7379836b7a6478266103880ff9d53df901337b4ea649a63259c728e8a52116633</originalsourceid><addsrcrecordid>eNqNUcFq4zAQFWULzbb9hTLH3YMbybIle28lpN2F0l1ICr0ZxRklSh0pSHJC_q8fVgWHPfc0zLx5783wCLlj9J7Rmo-x92tUPm7GuFYLmRf3rJDlBRmxMs-zWhTlNzKirC4zIaq3K_I9hA2ltBJMjMjHP-9W1oVoWligRW0iaO-2oCwk0e4Ixu5VMHuEEL2KuDpNYKeiQRsDHExcg3UWZnPADvdpnhrV9hGhdd5Z5Y8QjnaZNBF-vMzm04fJ7OcvSKtdP2w7DXGNYPEA3oT3wcho0w5wsjvBZypMe-92mM5b9WaJnbEYbsilVl3A23O9Jq-P0_nkd_b89-nP5OE5axmXZSa5rCsuFlKJQla5EIzyqqJa18uSL3VNGedyUWCCayV4XtatzCusVJkzJgTn10QMuq13IXjUzc6bbfqwYbQ5ZdH8z6I5Z9GcskhENhBdv_sq5xMCPJUJ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Prognostic benefit from an early invasive strategy in patients with non ST elevation acute coronary syndrome (NSTEACS): evaluation of the new risk stratification in the NSTEACS European guidelines</title><source>Alma/SFX Local Collection</source><source>EZB Electronic Journals Library</source><source>Oxford Journals</source><creator>Martinon-Martinez, J ; Alvarez Alvarez, B ; Gonzalez Ferrero, T ; Garcia-Rodeja Arias, F ; Otero Garcia, O ; Cacho Antonio, C ; Abou Jokh Casas, C ; Cordero, A ; Cid Alvarez, B ; Iglesias Alvarez, D ; Agra Bermejo, R ; Rigueiro Veloso, P ; Garcia Acuna, J M ; Gude Sampedro, F ; Gonzalez Juanatey, J R</creator><creatorcontrib>Martinon-Martinez, J ; Alvarez Alvarez, B ; Gonzalez Ferrero, T ; Garcia-Rodeja Arias, F ; Otero Garcia, O ; Cacho Antonio, C ; Abou Jokh Casas, C ; Cordero, A ; Cid Alvarez, B ; Iglesias Alvarez, D ; Agra Bermejo, R ; Rigueiro Veloso, P ; Garcia Acuna, J M ; Gude Sampedro, F ; Gonzalez Juanatey, J R</creatorcontrib><description>Abstract Objectives The objective of our work is to evaluate the prognostic benefit of an early invasive strategy in patients with high-risk NSTACS according to the recommendations of the 2020 clinical practice guidelines during long-term follow-up. Methods This retrospective observational study included 6454 consecutive NSTEACS patients. We analyze the effects of early coronary angiography (&lt;24 h) in patients with: (a) GRACE risk score &gt;140 and (b) patients with “established NSTEMI” (non ST-segment elevation myocardial infarction defined by an increase in troponins) or dynamic ST-T-segment changes with a GRACE risk score &lt;140. Results From 2003 to 2017, 6454 patients with “new high-risk NSTEACS” were admitted, and 6031 (93.45%) of these underwent coronary angiography. After inverse probability of treatment weighting, the long-term cumulative probability of being free of all-cause mortality, cardiovascular mortality and MACE differed significantly due to an early coronary interven- tion in patients with NSTEACS and GRACE &gt;140 [HR 0.62 (IC 95% 0.57–0.67), HR 0.62 (IC 95% 0.56–0.68), HR 0.57 (IC 95% 0.53–0.61), respectively]. In patients with NSTEACS and GRACE &lt;140 with established NSTEMI or ST/T-segment changes, the benefit of the early invasive strategy is only observed in the reduction of MACE [HR 0.62 (IC 95% 0.56–0.68)], but not for total mortality [HR 0.96 (IC 95% 0.78–1.2)] and cardiovascular mortality [HR 0.96 (IC 95% 0.75–1.24)]. Conclusions An early invasive management is associated with reduced all-cause mortality, cardiovascular mortality and MACE in NSTEACS with high GRACE risk score. However, this benefit is less evident in the subgroup of patients with a GRACE score &lt;140 with established NSTEMI or ST/T-segment changes. Funding Acknowledgement Type of funding sources: None.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehab724.1475</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2021-10, Vol.42 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Martinon-Martinez, J</creatorcontrib><creatorcontrib>Alvarez Alvarez, B</creatorcontrib><creatorcontrib>Gonzalez Ferrero, T</creatorcontrib><creatorcontrib>Garcia-Rodeja Arias, F</creatorcontrib><creatorcontrib>Otero Garcia, O</creatorcontrib><creatorcontrib>Cacho Antonio, C</creatorcontrib><creatorcontrib>Abou Jokh Casas, C</creatorcontrib><creatorcontrib>Cordero, A</creatorcontrib><creatorcontrib>Cid Alvarez, B</creatorcontrib><creatorcontrib>Iglesias Alvarez, D</creatorcontrib><creatorcontrib>Agra Bermejo, R</creatorcontrib><creatorcontrib>Rigueiro Veloso, P</creatorcontrib><creatorcontrib>Garcia Acuna, J M</creatorcontrib><creatorcontrib>Gude Sampedro, F</creatorcontrib><creatorcontrib>Gonzalez Juanatey, J R</creatorcontrib><title>Prognostic benefit from an early invasive strategy in patients with non ST elevation acute coronary syndrome (NSTEACS): evaluation of the new risk stratification in the NSTEACS European guidelines</title><title>European heart journal</title><description>Abstract Objectives The objective of our work is to evaluate the prognostic benefit of an early invasive strategy in patients with high-risk NSTACS according to the recommendations of the 2020 clinical practice guidelines during long-term follow-up. Methods This retrospective observational study included 6454 consecutive NSTEACS patients. We analyze the effects of early coronary angiography (&lt;24 h) in patients with: (a) GRACE risk score &gt;140 and (b) patients with “established NSTEMI” (non ST-segment elevation myocardial infarction defined by an increase in troponins) or dynamic ST-T-segment changes with a GRACE risk score &lt;140. Results From 2003 to 2017, 6454 patients with “new high-risk NSTEACS” were admitted, and 6031 (93.45%) of these underwent coronary angiography. After inverse probability of treatment weighting, the long-term cumulative probability of being free of all-cause mortality, cardiovascular mortality and MACE differed significantly due to an early coronary interven- tion in patients with NSTEACS and GRACE &gt;140 [HR 0.62 (IC 95% 0.57–0.67), HR 0.62 (IC 95% 0.56–0.68), HR 0.57 (IC 95% 0.53–0.61), respectively]. In patients with NSTEACS and GRACE &lt;140 with established NSTEMI or ST/T-segment changes, the benefit of the early invasive strategy is only observed in the reduction of MACE [HR 0.62 (IC 95% 0.56–0.68)], but not for total mortality [HR 0.96 (IC 95% 0.78–1.2)] and cardiovascular mortality [HR 0.96 (IC 95% 0.75–1.24)]. Conclusions An early invasive management is associated with reduced all-cause mortality, cardiovascular mortality and MACE in NSTEACS with high GRACE risk score. However, this benefit is less evident in the subgroup of patients with a GRACE score &lt;140 with established NSTEMI or ST/T-segment changes. Funding Acknowledgement Type of funding sources: None.</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNqNUcFq4zAQFWULzbb9hTLH3YMbybIle28lpN2F0l1ICr0ZxRklSh0pSHJC_q8fVgWHPfc0zLx5783wCLlj9J7Rmo-x92tUPm7GuFYLmRf3rJDlBRmxMs-zWhTlNzKirC4zIaq3K_I9hA2ltBJMjMjHP-9W1oVoWligRW0iaO-2oCwk0e4Ixu5VMHuEEL2KuDpNYKeiQRsDHExcg3UWZnPADvdpnhrV9hGhdd5Z5Y8QjnaZNBF-vMzm04fJ7OcvSKtdP2w7DXGNYPEA3oT3wcho0w5wsjvBZypMe-92mM5b9WaJnbEYbsilVl3A23O9Jq-P0_nkd_b89-nP5OE5axmXZSa5rCsuFlKJQla5EIzyqqJa18uSL3VNGedyUWCCayV4XtatzCusVJkzJgTn10QMuq13IXjUzc6bbfqwYbQ5ZdH8z6I5Z9GcskhENhBdv_sq5xMCPJUJ</recordid><startdate>20211012</startdate><enddate>20211012</enddate><creator>Martinon-Martinez, J</creator><creator>Alvarez Alvarez, B</creator><creator>Gonzalez Ferrero, T</creator><creator>Garcia-Rodeja Arias, F</creator><creator>Otero Garcia, O</creator><creator>Cacho Antonio, C</creator><creator>Abou Jokh Casas, C</creator><creator>Cordero, A</creator><creator>Cid Alvarez, B</creator><creator>Iglesias Alvarez, D</creator><creator>Agra Bermejo, R</creator><creator>Rigueiro Veloso, P</creator><creator>Garcia Acuna, J M</creator><creator>Gude Sampedro, F</creator><creator>Gonzalez Juanatey, J R</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20211012</creationdate><title>Prognostic benefit from an early invasive strategy in patients with non ST elevation acute coronary syndrome (NSTEACS): evaluation of the new risk stratification in the NSTEACS European guidelines</title><author>Martinon-Martinez, J ; Alvarez Alvarez, B ; Gonzalez Ferrero, T ; Garcia-Rodeja Arias, F ; Otero Garcia, O ; Cacho Antonio, C ; Abou Jokh Casas, C ; Cordero, A ; Cid Alvarez, B ; Iglesias Alvarez, D ; Agra Bermejo, R ; Rigueiro Veloso, P ; Garcia Acuna, J M ; Gude Sampedro, F ; Gonzalez Juanatey, J R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1375-7379836b7a6478266103880ff9d53df901337b4ea649a63259c728e8a52116633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martinon-Martinez, J</creatorcontrib><creatorcontrib>Alvarez Alvarez, B</creatorcontrib><creatorcontrib>Gonzalez Ferrero, T</creatorcontrib><creatorcontrib>Garcia-Rodeja Arias, F</creatorcontrib><creatorcontrib>Otero Garcia, O</creatorcontrib><creatorcontrib>Cacho Antonio, C</creatorcontrib><creatorcontrib>Abou Jokh Casas, C</creatorcontrib><creatorcontrib>Cordero, A</creatorcontrib><creatorcontrib>Cid Alvarez, B</creatorcontrib><creatorcontrib>Iglesias Alvarez, D</creatorcontrib><creatorcontrib>Agra Bermejo, R</creatorcontrib><creatorcontrib>Rigueiro Veloso, P</creatorcontrib><creatorcontrib>Garcia Acuna, J M</creatorcontrib><creatorcontrib>Gude Sampedro, F</creatorcontrib><creatorcontrib>Gonzalez Juanatey, J R</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martinon-Martinez, J</au><au>Alvarez Alvarez, B</au><au>Gonzalez Ferrero, T</au><au>Garcia-Rodeja Arias, F</au><au>Otero Garcia, O</au><au>Cacho Antonio, C</au><au>Abou Jokh Casas, C</au><au>Cordero, A</au><au>Cid Alvarez, B</au><au>Iglesias Alvarez, D</au><au>Agra Bermejo, R</au><au>Rigueiro Veloso, P</au><au>Garcia Acuna, J M</au><au>Gude Sampedro, F</au><au>Gonzalez Juanatey, J R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic benefit from an early invasive strategy in patients with non ST elevation acute coronary syndrome (NSTEACS): evaluation of the new risk stratification in the NSTEACS European guidelines</atitle><jtitle>European heart journal</jtitle><date>2021-10-12</date><risdate>2021</risdate><volume>42</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract Objectives The objective of our work is to evaluate the prognostic benefit of an early invasive strategy in patients with high-risk NSTACS according to the recommendations of the 2020 clinical practice guidelines during long-term follow-up. Methods This retrospective observational study included 6454 consecutive NSTEACS patients. We analyze the effects of early coronary angiography (&lt;24 h) in patients with: (a) GRACE risk score &gt;140 and (b) patients with “established NSTEMI” (non ST-segment elevation myocardial infarction defined by an increase in troponins) or dynamic ST-T-segment changes with a GRACE risk score &lt;140. Results From 2003 to 2017, 6454 patients with “new high-risk NSTEACS” were admitted, and 6031 (93.45%) of these underwent coronary angiography. After inverse probability of treatment weighting, the long-term cumulative probability of being free of all-cause mortality, cardiovascular mortality and MACE differed significantly due to an early coronary interven- tion in patients with NSTEACS and GRACE &gt;140 [HR 0.62 (IC 95% 0.57–0.67), HR 0.62 (IC 95% 0.56–0.68), HR 0.57 (IC 95% 0.53–0.61), respectively]. In patients with NSTEACS and GRACE &lt;140 with established NSTEMI or ST/T-segment changes, the benefit of the early invasive strategy is only observed in the reduction of MACE [HR 0.62 (IC 95% 0.56–0.68)], but not for total mortality [HR 0.96 (IC 95% 0.78–1.2)] and cardiovascular mortality [HR 0.96 (IC 95% 0.75–1.24)]. Conclusions An early invasive management is associated with reduced all-cause mortality, cardiovascular mortality and MACE in NSTEACS with high GRACE risk score. However, this benefit is less evident in the subgroup of patients with a GRACE score &lt;140 with established NSTEMI or ST/T-segment changes. Funding Acknowledgement Type of funding sources: None.</abstract><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehab724.1475</doi><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0195-668X
ispartof European heart journal, 2021-10, Vol.42 (Supplement_1)
issn 0195-668X
1522-9645
language eng
recordid cdi_crossref_primary_10_1093_eurheartj_ehab724_1475
source Alma/SFX Local Collection; EZB Electronic Journals Library; Oxford Journals
title Prognostic benefit from an early invasive strategy in patients with non ST elevation acute coronary syndrome (NSTEACS): evaluation of the new risk stratification in the NSTEACS European guidelines
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T18%3A16%3A44IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-oup_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prognostic%20benefit%20from%20an%20early%20invasive%20strategy%20in%20patients%20with%20non%20ST%20elevation%20acute%20coronary%20syndrome%20(NSTEACS):%20evaluation%20of%20the%20new%20risk%20stratification%20in%20the%20NSTEACS%20European%20guidelines&rft.jtitle=European%20heart%20journal&rft.au=Martinon-Martinez,%20J&rft.date=2021-10-12&rft.volume=42&rft.issue=Supplement_1&rft.issn=0195-668X&rft.eissn=1522-9645&rft_id=info:doi/10.1093/eurheartj/ehab724.1475&rft_dat=%3Coup_cross%3E10.1093/eurheartj/ehab724.1475%3C/oup_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rft_oup_id=10.1093/eurheartj/ehab724.1475&rfr_iscdi=true