Timing of Coronary Invasive Strategy in Non-ST-Segment Elevation Acute Coronary Syndromes and Clinical Outcomes: An Updated Meta-Analysis
| العنوان: | Timing of Coronary Invasive Strategy in Non-ST-Segment Elevation Acute Coronary Syndromes and Clinical Outcomes: An Updated Meta-Analysis |
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| المؤلفون: | Bonello, Laurent, Laine, Marc, Puymirat, Etienne, Lemesle, Gilles, Thuny, Franck, Paganelli, Franck, Michelet, Pierre, Roch, Antoine, Kerbaul, François, Boyer, Laurent |
| المساهمون: | Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Mediterranean Association for Research and Studies in Cardiology (MARS cardio), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Nord [CHU - APHM], Assistance Publique - Hôpitaux de Marseille (APHM), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), The authors thank Marie and Paul for the time devoted to this meta-analysis. They would also like to thank Emilie and Louise B. for their patience and careful work in data collection. Assistance-Publique Hôpitaux de Marseille provided technical support through grant PHRC-15-197., Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| المصدر: | JACC: Cardiovascular Interventions JACC: Cardiovascular Interventions, Elsevier/American College of Cardiology, 2016, pp.2267-2276. ⟨10.1016/j.jcin.2016.09.017⟩ JACC: Cardiovascular Interventions, 2016, pp.2267-2276. ⟨10.1016/j.jcin.2016.09.017⟩ |
| بيانات النشر: | HAL CCSD, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | [SDV]Life Sciences [q-bio], NSTE-ACS, MESH: Hemorrhage/etiology, MESH: Risk Assessment, MESH: Length of Stay, MESH: Risk Factors, timing, MESH: Percutaneous Coronary Intervention*/adverse effects, angiography, MESH: Acute Coronary Syndrome/diagnostic imaging, MESH: Acute Coronary Syndrome/therapy, MESH: Non-ST Elevated Myocardial Infarction/diagnostic imaging, MESH: Non-ST Elevated Myocardial Infarction/therapy, MESH: Treatment Outcome, MESH: Humans, MESH: Time-to-Treatment, percutaneous coronary intervention, MESH: Time Factors, MESH: Coronary Artery Bypass*/adverse effects, mortality, MESH: Coronary Angiography, MESH: Odds Ratio, MESH: Recurrence, MESH: Percutaneous Coronary Intervention*/mortality, MESH: Randomized Controlled Trials as Topic, MESH: Coronary Artery Bypass*/mortality, MESH: Acute Coronary Syndrome/mortality, MESH: Non-ST Elevated Myocardial Infarction/mortality, invasive |
| الوصف: | Comment in : Invasive Strategy After Non-ST-Segment Elevation Acute Coronary Syndrome: Timing and Controversies. [JACC Cardiovasc Interv. 2016]; International audience; OBJECTIVES: The aim of this study was to compare an early versus a delayed invasive strategy in non-ST-segment elevation acute coronary syndromes by performing a meta-analysis of all available randomized controlled clinical trials.BACKGROUND: An invasive approach is recommended to prevent death and myocardial infarction in non-ST-segment elevation acute coronary syndromes. However, the timing of angiography and the subsequent intervention, when required, remains controversial.METHODS: A previous meta-analysis of 7 randomized clinical trials comparing early and delayed invasive strategies in non-ST-segment elevation acute coronary syndromes with 3 new randomized clinical trials identified in a search of the published research (n = 10 trials, n = 6,397 patients) was updated.RESULTS: The median time between randomization and angiography ranged from 0.5 to 14.0 h in the early group and from 18.3 to 86.0 h in the delayed group. There was no difference in the primary endpoint of mortality (4% vs. 4.7%; random-effects odds ratio [OR]: 0.85; 95% confidence interval [CI]: 0.67 to 1.09; p = 0.20; I2 = 0%). The rate of myocardial infarction was also similar (6.7% vs. 7.7%; random-effects OR: 0.88; 95% CI: 0.53 to 1.45; p = 0.62; I2 = 77.5%). An early strategy was associated with a reduction in recurrent ischemia or refractory angina (3.8% vs. 5.8%; random-effects OR: 0.54; 95% CI: 0.40 to 0.74; p < 0.01; I2 = 28%) and a shorter in-hospital stay (median 112 h [interquartile range: 61 to 158 h] vs. 168 h [interquartile range: 90.3 to 192 h]; random-effects standardized mean difference -0.40; 95% CI: -0.59 to -0.21; p < 0.01; I2 = 79%). Major bleeding was similar in the 2 groups (3.9% vs. 4.2%; random-effects OR: 0.94; 95% CI: 0.73 to 1.22; p = 0.64; I2 = 0%).CONCLUSIONS: An early invasive strategy does not reduce the risk for death or myocardial infarction compared with a delayed strategy. Recurrent ischemia and length of stay were significantly reduced with an early invasive strategy. |
| اللغة: | English |
| تدمد: | 1936-8798 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=dedup_wf_001::7bf8ce838a62a90a2a5169325ca09427Test https://hal-amu.archives-ouvertes.fr/hal-01465797Test |
| رقم الانضمام: | edsair.dedup.wf.001..7bf8ce838a62a90a2a5169325ca09427 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19368798 |
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