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Clinical Guidelines
Authored By
Martinón-Martínez J, Álvarez Álvarez B, González Ferrero T, García-Rodeja Arias F, Otero García Ó, Cacho Antonio C, Abou Jokh Casas C, Zuazola P, Cordero A, Escribano D, Cid Alvarez B, Iglesias Álvare
Authored On
Wed, 09/01/2021 - 05:30
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Publication Date
Wed, 09/01/2021 - 12:00
Event Data
{"article_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.","author":"\"Martin\u00f3n-Mart\u00ednez, Jes\u00fas , \u00c1lvarez \u00c1lvarez, Bel\u00e9n , Gonz\u00e1lez Ferrero, Teba , Garc\u00eda-Rodeja Arias, Federico , Otero Garc\u00eda, \u00d3scar , Cacho Antonio, Carla , Abou Jokh Casas, Charigan , Zuazola, Pilar , Cordero, Alberto , Escribano, David , Cid Alvarez, Bel\u00e9n , Iglesias \u00c1lvarez, Diego , Agra Bermejo, Rosa , Rigueiro Veloso, Pedro , Garc\u00eda Acu\u00f1a, Jos\u00e9 Mar\u00eda , Gude Sampedro, Francisco , Gonz\u00e1lez Juanatey, Jos\u00e9 Ram\u00f3n\"","journal_title":"Clinical research in cardiology : official journal of the German Cardiac Society","issn":"1861-0692 ; Electronic","isbn":"","publication_date":"20210901","volume":"110","issue":"9","first_page":"1464","page_count":"9","accession_number":"33687519","doi":"10.1007\/s00392-021-01829-8","publisher":"Springer Medizin","doctype":"Journal Article; Observational Study","subjects":"Cardiology ","interest_area":["Cardiology"," Surgery"],"abstract":"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.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=33687519&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Martin\u00f3n-Mart\u00ednez J, \u00c1lvarez \u00c1lvarez B, Gonz\u00e1lez Ferrero T, Garc\u00eda-Rodeja Arias F, Otero Garc\u00eda \u00d3, Cacho Antonio C, Abou Jokh Casas C, Zuazola P, Cordero A, Escribano D, Cid Alvarez B, Iglesias \u00c1lvarez D, Agra Bermejo R, Rigueiro Veloso P, Garc\u00eda Acu\u00f1a JM, Gude Sampedro F, Gonz\u00e1lez Juanatey JR","Journal_Info":"Publisher: Springer Medizin Country of Publication: Germany NLM ID: 101264123 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1861-0692 (Electronic) Linking ISSN: 18610684 NLM ISO Abbreviation: Clin Res Cardiol Subsets: MEDLINE","Publication_Type":"Journal Article; Observational Study","Published_Date":"2021-09-01","Source":"Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2021 Sep; Vol. 110 (9), pp. 1464-1472. Date of Electronic Publication: 2021 Mar 09.","Languages":"English","Electronic_ISSN":"1861-0692","MeSH_Terms":"Practice Guidelines as Topic*, Acute Coronary Syndrome\/*diagnostic imaging , Coronary Angiography\/*methods , Non-ST Elevated Myocardial Infarction\/*diagnostic imaging, Acute Coronary Syndrome\/mortality ; Acute Coronary Syndrome\/therapy ; Aged ; Aged, 80 and over ; Europe ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Non-ST Elevated Myocardial Infarction\/mortality ; Non-ST Elevated Myocardial Infarction\/therapy ; Prognosis ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors","Subjects":"Acute Coronary Syndrome mortality, Acute Coronary Syndrome therapy, Aged, Aged, 80 and over, Europe, Female, Follow-Up Studies, Humans, Male, Middle Aged, Non-ST Elevated Myocardial Infarction mortality, Non-ST Elevated Myocardial Infarction therapy, Prognosis, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Acute Coronary Syndrome diagnostic imaging, Coronary Angiography methods, Non-ST Elevated Myocardial Infarction diagnostic imaging, Practice Guidelines as Topic","Title_Abbreviations":"Clinical research in cardiology : official journal of the German Cardiac Society","Volume":"110"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"33687519","RelevancyScore":"854","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"854.092468261719"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=33687519&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=33687519&authtype=shib&custid=ns346513&group=main&profile=eds"}
ISSN
1861-0692 ; Electronic
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https://search.ebscohost.com/login.aspx?direct=true&db=mdl&AN=33687519&authtype=shib&custid=ns346513
Additional Info
["Martin\u00f3n-Mart\u00ednez J, \u00c1lvarez \u00c1lvarez B, Gonz\u00e1lez Ferrero T, Garc\u00eda-Rodeja Arias F, Otero Garc\u00eda \u00d3, Cacho Antonio C, Abou Jokh Casas C, Zuazola P, Cordero A, Escribano D, Cid Alvarez B, Iglesias \u00c1lvarez D, Agra Bermejo R, Rigueiro Veloso P, Garc\u00eda Acu\u00f1a JM, Gude Sampedro F, Gonz\u00e1lez Juanatey JR","Publisher: Springer Medizin Country of Publication: Germany NLM ID: 101264123 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1861-0692 (Electronic) Linking ISSN: 18610684 NLM ISO Abbreviation: Clin Res Cardiol Subsets: MEDLINE","Journal Article; Observational Study","2021-09-01","Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2021 Sep; Vol. 110 (9), pp. 1464-1472. Date of Electronic Publication: 2021 Mar 09.","English","1861-0692","Practice Guidelines as Topic*, Acute Coronary Syndrome\/*diagnostic imaging , Coronary Angiography\/*methods , Non-ST Elevated Myocardial Infarction\/*diagnostic imaging, Acute Coronary Syndrome\/mortality ; Acute Coronary Syndrome\/therapy ; Aged ; Aged, 80 and over ; Europe ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Non-ST Elevated Myocardial Infarction\/mortality ; Non-ST Elevated Myocardial Infarction\/therapy ; Prognosis ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors","Acute Coronary Syndrome mortality, Acute Coronary Syndrome therapy, Aged, Aged, 80 and over, Europe, Female, Follow-Up Studies, Humans, Male, Middle Aged, Non-ST Elevated Myocardial Infarction mortality, Non-ST Elevated Myocardial Infarction therapy, Prognosis, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Acute Coronary Syndrome diagnostic imaging, Coronary Angiography methods, Non-ST Elevated Myocardial Infarction diagnostic imaging, Practice Guidelines as Topic","Clinical research in cardiology : official journal of the German Cardiac Society","110"]
Description
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.<br />Methods: This retrospective observational study included 6454 consecutive NSTEACS patients. We analyze the effects of early coronary angiography (< 24 h) in patients with: (a) GRACE risk score > 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.<br />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 intervention in patients with NSTEACS and GRACE > 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 < 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)].<br />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 < 140 with established NSTEMI or ST/T-segment changes.<br /> (© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)
Published Date
Fri, 02/20/2026 - 14:42
