In the NEWS
Immediate (rather than delayed) angiography may not alter outcomes in patients with acute coronary syndrome (ACS) without ST-segment elevation, suggests a study published in JAMA on September 2. Angiography allows physicians to determine the need for revascularization (surgery to remove blockage). From August 2006 to September 2008, investigators in France randomized 352 patients with ACS but without ST-segment elevation into one of two groups: those who underwent angiography right away, within a median time to intervention of 70 minutes, and those who underwent angiography the next work day (those arriving on a weekday had the procedure the next day, those arriving on a weekend had it on Monday), within a median time to intervention of 21 hours. Each center determined the course of antithrombotic treatment but kept it identical between study groups; anticoagulant treatment was left to the discretion of the investigators. Peak troponin I levels, an indication of heart damage and the study's primary end point, were not significantly different between the two groups. At the one-month follow-up, comparable numbers of patients in both groups had undergone urgent revascularization, had a myocardial infarction, or died from any cause.